Fauci on ‘highly specific and direct’ therapy for COVID-19

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Monoclonal antibodies could hold promise in treating and preventing COVID-19 if the results prove the effectiveness of clinical trials, the country’s leading infectious disease expert has said. MedPage today.

“There’s a lot of activity and it’s a very focused, very specific, direct antiviral approach for a number of diseases. The success of Ebola has been very encouraging, ”said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID).

Recently highlighted as an effective treatment for Ebola, monoclonal antibodies are currently being investigated as a potential treatment for HIV, as well as COVID-19. This month, the NIH highlighted monoclonal antibody trials with several different COVID-19 patient populations: ambulatory patients with COVID-19, patients hospitalized with the disease, and even a trial in household contacts of confirmed cases, where therapy has been used as prophylaxis.

Fauci explained how the mechanism of monoclonal antibodies “is really that of a direct antiviral”.

“It’s like getting a highly, highly concentrated and highly, highly specific neutralizing antibody. So the mechanism involved is to prevent the virus from essentially entering its target cell in the body and essentially interrupting the course of the infection, ”he said.

While Fauci noted the success of monoclonal antibodies in treating Ebola, he added that they are impractical for other viruses that only last a day or two, where the virus may already be cleared once the patient receives treatment.

“If you have a sufficiently severe and prolonged illness, like what we have seen with Ebola, and what we are currently seeing with COVID-19, then you have enough opportunity for the monoclonal antibody to actually work,” at -he adds.

Monoclonal antibodies are currently being given intravenously, although Fauci said if the treatment works, “you’re trying to switch it to a form where you can give it subcutaneously or intramuscularly,” a much more convenient way. administer the therapy.

He also explained the difference between monoclonal antibodies and convalescent plasma, describing them as “extremely pure”, due to their homogeneous nature. Therefore, recently published side effects observed in convalescent plasma trials in patients with COVID-19 may not apply.

“The difference between monoclonal antibodies and convalescent plasma is that the plasma contains a lot of other things, which could lead to allergic and other reactions,” said Fauci. “Theoretically, there are more complex factors in plasma than there are with a monoclonal antibody. ”

In the end, when asked if any of his patients asked him about monoclonal antibodies, Fauci said he would say it is a “promising form of therapy” .

“Many of them are still in clinical trials and are not available for routine use, but the data that has recently accumulated indicates that this is a very promising form of prevention and control. treatment, ”he noted.

  • Molly Walker is associate editor, covering infectious diseases for MedPage Today. She is passionate about evidence, data and public health. To follow

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