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Mixed Monoclonal Antibody Treatment Raises Hope for Indian COVID Patients

© REUTERS / AMIT DAVEA healthcare worker gives a dose of COVISHIELD, a coronavirus disease (COVID-19) vaccine manufactured by Serum Institute of India, to a woman inside a classroom of a school, which has been converted into a temporary vaccination centre, in Ahmedabad, India, May 1, 2021
A healthcare worker gives a dose of COVISHIELD, a coronavirus disease (COVID-19) vaccine manufactured by Serum Institute of India, to a woman inside a classroom of a school, which has been converted into a temporary vaccination centre, in Ahmedabad, India, May 1, 2021 - Sputnik International, 1920, 27.05.2021
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Mixed monoclonal antibody treatment (Casirivimab and Imdevimab) is now available in India. The treatment gained popularity after then-US President Donald Trump was prescribed it last year to treat COVID-19.

Mixed monoclonal antibody treatment made headlines last year when then-US President Donald Trump was prescribed it to treat COVID-19. It is now available in India. On Wednesday, India's first COVID-19 patient treated with mixed monoclonal antibodies was discharged from a hospital in Haryana a day after he was administered the jab. The patient, an 82-year-old man with multiple comorbidities, went home after getting the shot at the Medanta Hospital. Indian doctors are hopeful that this treatment will help in minimising hospitalisations, ease the burden on the healthcare system, and play a key role in treating high-risk patients before their condition worsens.

On Monday, the Switzerland-based drugmaker Roche and Cipla announced the availability of the first batch of the antibody cocktail (Casirivimab and Imdevimab) in India for the treatment of mild to moderate COVID-19 patients who are at high risk. As per reports, the second batch of the treatment will be made available by mid-June. Recently, the Central Drugs Standards Control Organisation (CDSCO) had provided emergency use authorisation for the antibody cocktail (Casirivimab and Imdevimab) in India. Meanwhile, Cipla will distribute the product in India through leading hospitals and COVID treatment centres.

"The therapy is being looked at as something that would help people who have been vaccinated but still contracted the infection. It is also anticipated that this course of treatment would be beneficial for children above 12 years, considering fear of a third wave that may put children at greater risk. If introduced at an early stage, this cocktail can prove to be a game-changer in the treatment of COVID-19 in the coming days. It has been seen that this hybrid antibody cocktail has 85% efficacy as compared to other in-demand anti-viral drugs and prevents mortality to a great extent. As far this efficacy is concerned, no other drug has been able to achieve it, provided it is given at the initial stages", Dr Yash Javeri, Critical Care, Anesthesia and Emergency Medicine, at the Regency Superspecialty Hospital in Lucknow told Sputnik.

The monoclonal antibody "cocktail", developed at the Vanderbilt University Medical Centre (VUMC), has proven to be effective in neutralising the COVID-19 virus and has been successful in curbing all known variants of the virus, experts say.

Casirivimab and Imdevimab are human immunoglobulin G-1 (IgG1) monoclonal antibodies produced by recombinant DNA technology. These antibodies are specifically directed against the spike protein of SARS-CoV-2, designed to block the virus' attachment and entry into human cells. This mixed antibody treatment, which has been used extensively in the US and Europe, mimics the immune system's ability to fight off viruses and other harmful pathogens.

The antibody cocktail is to be administered for the treatment of mild to moderate coronavirus disease 2019 (COVID-19) in adults and paediatric patients (12 years of age or older, weighing at least 40 kg) who are confirmed to be infected with SARS-CoV-2 and who are at high risk of developing severe COVID-19, but do not require oxygen.

On Thursday, Zydus announced a biological therapy called ZRC-3308 to treat mild COVID-19. The pharmaceutical company is now seeking approval from the Drugs Controller General of India (DCGI) to undertake clinical trials for a monoclonal antibody cocktail that can neutralise COVID. ZRC-3308 is a cocktail of 2 anti-SARS-CoV-2 monoclonal antibodies. It is noteworthy that Zydus is the only Indian company to have developed a neutralising monoclonal antibody-based cocktail to treat COVID-19.

Some doctors have also said that this cocktail treatment is a good step for families where one or more members are already infected and others too are showing symptoms. However, the price of this treatment is on the higher-end, which will pose a challenge for those patients who can't afford this.

"Considering its effectiveness and subsequent increased demand, the government may work on an agreement with the pharma companies to bring down the price", Dr Javeri said. 

The price of each dose is a little over ₹ 59,000 ($812) and a multi-dose pack - each pack can treat two patients - costs ₹ 1.19 lakh ($1,638). Annother limitation of this treatment is that it is only recommended for high-risk people like the elderly and people with existing comorbidities.

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