The World Health Organisation (WHO), revising treatment guidelines for Covid-19, has strongly advised against the use of two antibody drugs - sotrovimab and casirivimab-imdevimab. WHO said that these drugs are likely to be ineffective against currently circulating variants such as Omicron. As a result, they have also fallen out of favour with the US health regulator.
On Thursday, WHO experts said they strongly advised against the use of the two therapies in patients with Covid-19, reversing previous conditional recommendations endorsing them, as part of a suite of recommendations published in the British Medical Journal.
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The two therapies - which are designed to work by binding to the spike protein of SARS-CoV-2 to neutralise the virus' ability to infect cells - were some of the first medicines developed early in the pandemic. The note read, "After weighing up all the evidence, the panel judged that almost all well-informed patients would not choose to receive sotrovimab or casirivimab-imdevimab."
The decision to not use the monoclonal antibodies for patients with Covid-19 was take after the group considered in vitro (lab-based) neutralisation data.
"… sotrovimab and casirivimab-imdevimab evaluated in clinical trials have meaningfully reduced neutralisation activity of the currently circulating variants of Sars-CoV-2 and their subvariants. There was consensus among the panel that the absence of in vitro neutralisation activity strongly suggests absence of clinical effectiveness of these monoclonal antibodies," they said.
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Experts in India have welcomed WHO's recommendation and said that there was ample evidence to suggest that monoclonal antibodies will not work anymore.
Dr Yatin Mehta, Chairman, Institute of Critical Care and Anaesthesiology, Medanta-The Medicity, Gurugram, said, "In major Indian cities, antibodies have been used on select patients but that was in the previous wave. These drugs are directed against the spike protein and any changes in the spike protein would mean that they won’t work unless the drugs are modified as well. Ministry of Health had already indicated this and now even WHO has announced, which makes perfect sense."
