The science continues to confirm the efficacy of monoclonal antibodies as an effective treatment for COVID-19 – if applied early and proactively after infection. As this and other studies point out, “these are not normal times” – and urge that the public health and healthcare communities take action “ensure that monoclonal therapies can be provided to patients who are most likely to benefit.”
As reported by Gottlieb et al,1 the proportion of patients with COVID-19–related hospitalizations or emergency department visits was 5.8% (9 events) for placebo, 1.0% (1 event) for 700 mg of bamlanivimab, 1.9% (2 events) for 2800 mg of bamlanivimab, 2.0% (2 events) for 7000 mg of bamlanivimab, and 0.9% (1 event) for the combination therapy.
Cases of COVID-19 in the US continue to surge3; each day brings new records for hospitalizations and deaths with concerns that emerging genetic variants may further hasten spread4 while vaccination efforts to date have been disappointing. During normal times, an interim analysis of an ongoing clinical trial usually would not be published, but these are not normal times. Even though monoclonal antibodies likely improve clinical outcomes in selected patients, the studies needed to answer remaining questions on the utility of treatment (which patients can benefit and in what circumstance) are unlikely to become available in a timely manner.
As has been the case throughout the pandemic, clinicians face an ever-changing treatment narrative and must make decisions based on the best information available. While the world waits for widespread administration of effective vaccines and additional data on treatments, local efforts should work to improve testing access and turnaround time and reduce logistical barriers to ensure that monoclonal therapies can be provided to patients who are most likely to benefit.5JAMA Network, January 21, 2021. doi:10.1001/jama.2021.0585