Monoclonal antibody treatment service to begin for hospitalised COVID-19 patients in October 2021

Exclusive: Patients in hospital in England with COVID-19, and later in the community, could start receiving neutralising monoclonal antibodies as a treatment for the disease by early October 2021.

Patients in hospitals in England could start receiving neutralising monoclonal antibodies (nMABs) as a treatment for COVID-19 by early October 2021, chief pharmacists have confirmed.

They said treatment provision would later be extended to COVID-19 patients in community settings.

The confirmation follows the approval of nMAB treatment Ronapreve — a cocktail of two monoclonal antibodies: casirivimab and imdevimab — by the Medicines and Healthcare products Regulatory Agency (MHRA) in August 2021.

Simon Stevens, then chief executive of NHS England, had advised delegates at the NHS Confederation Conference in June 2021 that the NHS should “gear up” for the provision of nMABs so that the treatment can “immediately begin to be deployed” when it becomes available.

A series of confidential NHS documents, seen by The Pharmaceutical Journal, subsequently revealed the NHS’s plans for administering the treatment in the community.

These include prioritising patients with an impaired immune response, or who are unvaccinated, and the suggestion of a ‘hospital at home-type service’ for the most vulnerable patients who are unable to present to outpatient facilities.

The documents also said that in-hospital treatment with nMABs could be available when a patient has a confirmed case of COVID-19, is receiving corticosteroids and has negative baseline serum anti-spike antibodies against SARS-CoV-2.

Raliat Onatade, group chief pharmacist and clinical director for medicines optimisation at Barts Health NHS Trust, told The Pharmaceutical Journal: “We expect that the service will initially be rolled out for inpatients who meet the treatment criteria, followed by community roll-out.” 

“We haven’t yet received the clinical commissioning policy, but we expect to start administering to patients in or before early October [2021],” she said.

The plan for rolling out the treatment and its timeframe were confirmed by an additional chief pharmacist involved in the NHS’s preparations for the service.

According to the NHS documents, hospital chief pharmacists were to be involved in developing the standard operating procedure “for ordering, preparation and administration of the treatment”, as well as overseeing treatment supply, cold chain storage and stock management for reporting “into the national reporting system”.

In June 2021, the randomised evaluation of COVID-19 therapy (RECOVERY) trial found that Ronapreve reduced the risk of death and the length of hospital stay for seronegative hospitalised patients with severe COVID-19.

The Department of Health and Social Care said it had no further update to add to the comments made by the chief pharmacists.

READ MORE: Pharmacists could assess patients’ suitability for COVID-19 monoclonal antibody treatment

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Citation
The Pharmaceutical Journal, PJ, September 2021, Vol 307, No 7953;307(7953)::DOI:10.1211/PJ.2021.1.105169