The phone does not stop ringing in Delhi’s Manipal Hospital. Concerned families of COVID patients are in constant phone calls, with the majority insisting their loved ones be given the latest wonder treatment – the monoclonal antibody (mAb) cocktail.
We’ve been there before. If there was a demand for hydroxychloroquine and plasma therapy in the first wave, the second wave saw remdesivir, ivermectin, steroids such as dexamethasone and tocilizumab as drugs. This time, it’s MAB.
The antibody cocktail was shown to be highly effective in preventing serious illness and death during the second wave. Dr Naresh Trehan, president of Medanta-The Medicity, the first hospital to start treatment in the country, said at the time that it “shows great promise in reducing hospitalization rates and even given to children”. May go”. MaBs are lab-generated antibodies that mimic antibodies in the human body when injected for a rapid immune response against COVID. Administered intravenously or subcutaneously over a 2-4 hour procedure in a hospital setting, antibodies target the virus’s spike proteins to prevent them from replication within the body.
In May 2021, India’s Central Drugs Standard Control Organization granted emergency use authorization to Regeneron and its partner Roche for their cisarivimab and imdevimab antibody cocktails, known by the brand name Regene-CoV. The cost of a single dose in India ranges from Rs 59,750 to Rs 65,000. Global data from 4,567 patients published by Roche in March 2021 showed that the antibody cocktail reduced hospitalization or death by a fifth and shortened the duration of symptoms or hospitalization by four days. The study was conducted at a time when the delta variant was the dominant COVID strain in the world. “The antibody cocktail has significantly reduced the progression of the disease,” says Dr Rahul Pandit, Director, ICU at Fortis Hospitals, Mumbai. “But it is important that they are administered at an early stage, usually 3-5 days after the onset of symptoms.”
However, many experts are skeptical about its effectiveness against Omicron. On 16 December, Regeneron issued a statement saying that its antibody therapy “had a lower potency than Omicron but was active against the dominant delta variant”. A pre-print in BioRxiv studied the efficacy of nine antibody cocktails against Omicron and found it to be quite resistant.
Pharmaceutical firms have already started testing new antibodies for use against Omicron. Preliminary research shows promise in particular for two—otrovimab, developed by San Francisco-based Vir Biotechnology and London-based GSK, and DXP-604, developed by Beijing-based BeGene and Singlomix. Neither is currently available in India.
However, there is already a new drug on the market that private hospitals and physicians are free to prescribe to patients. Merck’s antiviral pill Molnupiravir received the EUA in India by the DCGI (Drugs Controller General of India) last month. More than a dozen laboratories including Cipla, Dr Reddy’s and Sun Pharma will produce the Merck pill, as it is popularly known, in India. With a starting price of Rs 1,399 for a five-day course, studies show it slashes hospitalizations and deaths in early-stage infections by half. ICMR chief Dr Balram Bhargava, however, cautions against the side effects of the pill and it has not been included in the national COVID treatment guidelines. These side effects can trigger fetal and genetic defects as well as cartilage damage. According to Dr Bhargava, the pill is also dangerous for pregnant women and needs to be taken along with three months of contraception.
A second antiviral pill by Pfizer, nirmatrelvir, is also due for approval in India soon. Results from Phase II and III clinical trials show that it reduced the risk of hospitalization or death by 89 percent. “It takes some time to start prescribing new drugs. You have to be alert and keep in mind the various side effects. Overall, Omicron had mild symptoms, mostly infecting the upper respiratory tract. LNJP Hospital, Delhi “At this point people at high risk or showing signs of progressing to serious disease should be given the drug,” says Dr S Kumar, medical director of the US.
tablet board
Producer by Pfizer
Suppliers in India: n/a
Medicine Type: anti viral
Approval: In process, decision awaited
MoHFW guidelines include: No
Face value: n/a
effect: Results from Phase II and III clinical trials showed it reduced the risk of hospitalization or death by 89 percent
Molnupiravir by Merco
Suppliers in India: Cipla, Sun Pharma, Dr Reddy’s Labs and nine other companies
Medicine Type: anti viral
Approval: Yes
MoHFW guidelines include: No
Face value: Rs 1,399 for a 5-day course
effect: 50% reduction in hospitalization and death from early-stage infections
Roche by Ronaprev
Suppliers in India: Rosh and Cipla
Medicine Type: Combination of two monoclonal antibodies, casirivimab and imdevimab”
Approval: Yes
MoHFW guidelines include: Yes
Face value: Rs 59,750 per dose
effect: Trials have shown that it shortens hospital stays by up to four days and reduces the risk of death by a fifth
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