August 13, 2021

COVID-19 Monoclonal Antibody Treatments in Your Practice Setting

The Washington State Department of Health is asking physicians and providers to ensure COVID-19 patients across Washington can access monoclonal antibody treatments, which a growing body of research has shown can reduce a patient's viral load and prevent the need for hospitalization. Some monoclonal antibodies can now be administered subcutaneously in a provider's office, and some are being offered by the federal government to physicians and providers for free.

An urgent request from Dr. Bob Lutz

Last week, Washington's COVID-19 Medical Advisor Bob Lutz, MD, MPH, issued the following request to physicians and providers statewide:

Dear Health Care Providers,

Your work has been crucial for people across the state during the COVID-19 pandemic. Treatment options for COVID-19 have advanced and we now have more tools to prevent hospitalization and death. One tool is monoclonal antibody treatment. Monoclonal antibodies are laboratory-made proteins used to fight active COVID-19 infections. They provide protection when a person's immune system cannot or has not had time to respond, neutralizing or killing SARS-CoV-2.

Monoclonal antibody treatment are recommended as part of the National Institutes of Health COVID-19 Treatment Guidelines and the Infectious Disease Society of America Guidelines on the Treatment and Management of Patients with COVID-19.

These treatments are effective, and they are now easier to use. A growing body of research has shown that monoclonal antibody treatments can reduce a patient's viral load and prevent the need for hospitalization. These treatments are primarily given by IV infusion. However, some monoclonal antibodies can now be administered subcutaneously in a provider's office, so patients no longer need to go to a special site for an IV infusion. That means the treatments are now easier for patients to access, as there is more flexibility in how and where you can administer them.

The U.S. Food and Drug Administration has granted emergency use authorization for several monoclonal antibody treatments. In Washington state, given the mix of SARS-CoV-2 variants, the FDA recommends two monoclonal antibody treatments: REGEN-COV and Sotrovimab. The federal government is offering REGEN-COV to providers for free.

So far, these treatments have been shown to be effective against all SARS-CoV-2 variants.

What you can do to help

The Washington State Department of Health is asking physicians and providers to ensure COVID-19 patients across Washington can access monoclonal antibody treatments. Here's what you can do to help:

• Consider using monoclonal antibodies to treat eligible patients with mild to moderate COVID-19 illness. Patients are eligible if they are 12 years of age or older, weigh at least 40 kg, and are at high risk of serious COVID-19 illness that may lead to hospitalization or death.
• Advocate to have monoclonal antibody treatments readily available in your clinic. Talk to your Chief Medical Officer and pharmacy partners about offering the treatment in your clinic. If you don't have an infusion center at your clinic, consider keeping subcutaneous dosing options on hand.
• If monoclonal antibodies are not available at your clinic, know which nearby clinics are offering the treatment. It is important to know where patients can find the treatment in their community so you can refer them quickly and avoid delay in treatment. You can use this map to find out where monoclonal antibody treatments may be available near you. Call to confirm that the treatment is available before referring patients to another clinic.

For more information, contact Ezra.Stark@doh.wa.gov or see our guidance for the use of monoclonal antibody products to treat COVID-19. This document is being updated with most recent clinical recommendations. Check back soon for the latest information.

Monoclonal antibody treatment can save lives and improve outcomes related to COVID-19 illness. Thank you for helping to make this treatment available for eligible COVID-19 patients, and for everything you are doing to keep Washingtonians healthy."

Bob Lutz, MD, MPH

Medical Advisor, COVID-19

Download Dr. Lutz's Dear Provider letter to help disseminate broadly to the physician and provider community.