New treatment to prevent severe Covid-19 cases introduced in RAK hospital

Drug mimics valuable antibodies in patients not yet producing their own

RAK Hospital is using Bamlanivimab to prevent Covid-19 patints from developing severe symptoms. Reem Mohammed / The National

A UAE hospital has introduced an additional treatment for Covid-19 patients to prevent them from developing severe symptoms.

RAK Hospital is said to be one of the first hospitals in the Emirates to offer Bamlanivimab, a monoclonal antibody shown to cut the risk that people infected with the coronavirus will fall seriously ill.

In November, American regulators granted the drug an emergency use authorisation to treat vulnerable patients after it was shown to be effective in individuals with mild to moderate Covid-19 symptoms.

Monoclonal antibodies are lab-made antibodies that complement the immune system by, in this case, latching on to the spike protein of Sars-CoV-2, the coronavirus that causes Covid-19.

“Normally the patient’s immune system produces antibodies, but this takes time and the patient can develop severe symptoms during the immune response,” said Dr Jean Marc Gauer, the hospital’s chief executive.

“The medication consists of antibodies similar to the antibodies of patients who recovered from the disease, thereby allowing an immediate response to the virus and avoiding severe disease.”

In trials on patients likely to develop severe symptoms, only 3 per cent of those given the drug went on to require a hospital stay or emergency treatment, compared with 10 per cent of those administered a placebo.

However, the US Food and Drug Administration reported the drug was ineffective in patients with severe disease and, in line with this, it is not offered to those already in hospital with Covid-19.

The drug is given as a one-time intravenous infusion in a patient’s arm, lasting about an hour, with a further hour of observation required afterwards.

It may be particularly useful for individuals over 65 or with high blood pressure, who have tested positive and are more at risk, the hospital said.

However, the treatment is not suitable for everyone. Those with low blood oxygen levels or with a high breathing or heart rate cannot be given the drug. It is also not administered to pregnant women.

Produced by the US pharmaceutical company Eli Lilly, Bamlanivimab was the first monoclonal antibody treatment to gain an EUA from the FDA when it was given the green light in early November.

Prof Paul Hunter, an infectious diseases specialist and professor of medicine at the University of East Anglia in the UK, said the evidence showed monoclonal antibodies provided benefits when high-risk patients were treated early.

“You wouldn’t give this to a fit 20-year-old, but to somebody who has not been vaccinated and maybe has got underlying diseases, cancer or something like that,” he said.

“It probably wouldn’t provide additional benefit in people who’ve been vaccinated, and it’s not clear whether this would work against the South African variant.”

The highly transmissible South African coronavirus variant has alterations in its spike protein that make it better able to evade the protection given by vaccines and, possibly, monoclonal antibodies.

Prof David Taylor, professor emeritus of pharmaceutical and public health policy at University College London, said medical literature indicated that Bamlanivimab was also useful as a preventive drug, such as to protect vulnerable people who may have been exposed to the virus.

In January this year, Eli Lilly reported the drug did prevent Covid-19, because it reduced the risk of nursing home residents developing the disease by 80 per cent.

“The drawback of producing monoclonal antibodies is they’re relatively expensive and they have to be infused, so the delivery system is expensive, so it’s a high-cost care option for people in specific circumstances,” he said.

RAK Hospital's rehab centre for Long Covid patients