Antibody treatment for COVID clearly shown to be effective
By Rick Ruggles rruggles@sfnewmexican.com
Nov 27, 2021 Updated Nov 28, 2021 12
Laboratory-made monoclonal antibodies have helped Sergio Molinar of Albuquerque overcome both lymphoma and COVID-19.
Luis Sánchez Saturno/The New Mexican
The coronavirus pandemic has focused attention on a fairly new form of therapy, and Sergio Molinar knows more about it than most.
That’s because the therapy, using laboratory-made monoclonal antibodies, helped him overcome both lymphoma and the coronavirus.
“And the results have been magnificent,” said Molinar, who lives in Albuquerque. “Every day is a blessing for me.”
Physicians and hospitals in New Mexico and nationwide have upped the antibodies’ use over the past year for certain coronavirus patients. They are a comparatively new creation of science and medicine, and are also utilized against some cancers, rheumatoid arthritis, blood disorders, ebola and the respiratory disease RSV.
Monoclonal antibodies are derived from a clone of a cell that then produces large quantities of identical copies of the antibody. The antibodies are placed in a patient with the goal of blocking the virus from connecting to and entering cells.
First fully licensed for care in the mid-1980s, doctors deploy monoclonal antibodies in cases of COVID-19 against mild and moderate sickness, and only for patients with certain conditions. Depending on the doctor you speak to and study you read, the antibodies’ effectiveness ranges from 60 percent to 85 percent in keeping patients out of the hospital.
The antibodies, which are typically infused intravenously, are a vital early treatment for coronavirus patients including the elderly, obese or those with diabetes, high blood pressure, weakened immune systems, chronic kidney or chronic lung disease, those getting immunosuppressive treatments and some other patients.
The manufactured antibodies mimic the immune system’s response to disease. They must be administered within the first 10 days of symptoms of the coronavirus. Their effectiveness in patients with prolonged symptoms isn’t clear, according to an article this summer in The BMJ, a British medical journal.
Molinar first received monoclonal antibodies when he was treated for lymphoma, a cancer in the lymphatic system, in 2019. He underwent chemotherapy and still occasionally receives monoclonal antibodies as a form of maintenance therapy.
Dr. Malcolm Purdy, a cancer specialist with Albuquerque-based Lovelace Health System, oversaw his lymphoma care and said Molinar is in remission. They hope to end the maintenance therapy in March.
Purdy said when monoclonal antibodies began to be used against lymphoma roughly 20 years ago, the therapy “changed the landscape” in fighting that form of cancer.
“This is a technology that has markedly increased in its use across the [medical] system,” he said. “I think the technology that is behind this is unbelievable.”
Doctors said monoclonal antibodies aren’t stand-ins for coronavirus vaccinations. “This is not a substitute for a vaccine,” said Dr. David Gonzales, chief medical officer at CHRISTUS St. Vincent Regional Medical Center in Santa Fe.
Nevertheless, Gonzales said, the antibodies have been shown to be “quite safe and quite effective” for patients who qualify.
After Molinar was diagnosed with coronavirus in the spring, Purdy immediately recommended infusion with monoclonal antibodies tailored to fight COVID-19. Molinar had received his coronavirus vaccinations, but his body still didn’t produce enough antibodies to suppress the disease.
Molinar, who suffered fevers and chills with COVID-19, said he felt better a day or two after receiving the antibodies.
Molinar, 41, a longtime baseball player, put it in sports terms: “It takes a team to win, so Dr. Purdy [and] his staff have been a championship team.”
Like so many things involving COVID-19, treatments for the illness are controversial. Monoclonal antibodies have the potential to produce side effects, including fever, nausea, shortness of breath and low blood pressure, although doctors interviewed said they are rare.
Other treatments suggested by some, including ivermectin and hydroxychloroquine, are generally scorned by the medical community. Dr. Karl Robinson, an Albuquerque physician who favors homeopathic treatments, said that based on his reading, he doesn’t think those alternatives should be dismissed.
Robinson said he has no reason to frown upon monoclonal antibodies, either. But he said regulatory agencies and medical leaders in Washington, D.C., are “all in the pocket of Big Pharma,” so they are inclined to scoff at unconventional therapies. He also said American medicine fails by not promoting vitamin D, vitamin C and zinc to fortify the body against disease.
Dr. Ryan Bariola, co-chairman of the COVID-19 therapeutics committee at the University of Pittsburgh Medical Center, said his institution has had “great success” with monoclonal antibodies. Bariola, an infectious disease specialist, said ivermectin and hydroxychloroquine have been “fairly evaluated” and found ineffective.
The coronavirus and therapies for COVID-19 are “new and rapidly changing, and that can be frustrating for people,” he said. He added that wearing a mask, distancing, hand-washing and getting vaccinated are the best tactics.
“Prevention,” he said, “beats treatment every time.”
Dr. Arand Pierce of Presbyterian Healthcare Services said a patient needs a referral from a licensed health care provider to get the therapy. But those can be obtained from providers in an emergency department or urgent care clinic.
“I think it’s really done wonders for our community, keeping people out of the hospital,” said Pierce, medical director for infusion services with Presbyterian. His system has treated about 3,700 patients with monoclonal antibodies over the past year, he said.
“We’re treating 55 patients today,” he said last week, referring strictly to Presbyterian Hospital in Albuquerque.
Monoclonal antibodies are offered by many New Mexico hospitals and systems, including the 10-bed Guadalupe County Hospital in Santa Rosa. The facility gives about a dozen monoclonal antibody treatments a week. CHRISTUS St. Vincent used the treatment for 31 patients during a recent seven-day period.
The cost of the antibodies themselves are covered by the federal government. Administration of the therapy at the hospital is covered by Medicare and Medicaid and by many commercial insurance programs. Guadalupe County Hospital Administrator Christina Campos said insurers would rather see a patient get the therapy than cover the expense of a hospitalization.
Adrianna Salazar started getting feverish and achy one day in September and was diagnosed with COVID-19 the next day. She hadn’t been vaccinated. Her little sister, Naomi, dug around on the internet and found references to monoclonal antibodies.
Salazar, 26, has asthma and received the antibody infusion on about the eighth day of experiencing symptoms. The next day, the Albuquerque resident’s fever broke, the aches began to dissipate and her appetite returned, she said.
“I’m doing fantastic,” she said Friday. “I’m 100 percent.”
Her mother, Yvonne Salazar, said her only dismay is how little hospitals and the American medical system have publicized the therapy.
“It was a very scary time,” the mother said. “And this was an answer to our prayers.”