The COVID-19 Monoclonal Antibody Playbook

As cases of the highly transmissible Omicron variant of SARS-Cov-2 send new COVID-19 cases skyrocketing during the holiday season, clinicians and care teams are again bearing down for a difficult winter season of treating severe disease.

At the Allegheny Health Network (AHN), utility of monoclonal antibody infusions has become as informed and refined as they need it to be to help mitigate severe COVID-19 outcomes.

In an interview with HCPLive, Amy Crawford-Faucher, MD, AHN Vice Chair of the Primary Care Institute & Family Medicine, discussed how the health network has identified and prioritized COVID-19-positive populations for monoclonal antibody eligibility.

Namely, Crawford-Faucher discussed the “top 4” patient populations in need of consideration for the effective therapy regimen:

• Active chemotherapy recipients
• Transplant recipients
• Immunocompromised patients
• Pregnant women

Beyond that, the care teams at the outpatient infusion centers focus on age, clinical, and demographic factors that could indicate high risk.

“The request is definitely on the rise, I think primarily because more people are getting tested,” Crawford-Faucher said. “They may have mild disease, but all of a sudden more people are realizing they have COVID, so the interest in monoclonal antibodies has increased too.”

Crawford-Faucher also touched on the “fascinating” disparity between patients questioning well-studied COVID-19 vaccines versus quickly accepted monoclonal antibody regimens without worry, how effective the regimens have been in high-risk patients, and the unique care teams that collaborate on treatment.

She also discussed the particular burden of timing that goes into initiating monoclonal antibody treatment in patients.

“It’s varied,” Crawford-Faucher said. “I think that we know that the earlier in the course of disease that you get the monoclonal antibodies, the more effective they are—but that’s really the onset of symptoms, not the actual diagnosis. You might right outside the window of when we can fit you in.”