The All-Russian Public Organization for Patient Assistance “Association of Oncological Patients” Hello! ” in the temporary recommendations for the treatment of COVID-19, however, not everyone in need of treatment now has the opportunity to receive them.
The authors of the letter draw attention to the fact that vaccination is contraindicated in some categories of patients, for example, patients with malignant neoplasms: they are constantly on immunosuppressive therapy, which increases their susceptibility to COVID-19 infection. According to the president of the patient organization “Hello!” Irina Borova, innovative drugs based on monoclonal antibodies – kasirivimab + imdevimab, bamlanivimab + etesevimab, sotrovimab, regdanvimab – could reduce the risk of a severe course of coronavirus in such patients.
In October, the Ministry of Health of the Russian Federation released the 13th version of temporary guidelines for the prevention and treatment of a new coronavirus infection. It clarifies the possibilities of using neutralizing monoclonal antibodies in the therapy of COVID-19. The Ministry of Health has identified priority patient groups that are considered risk groups for the severe course of coronavirus. The categories identified by the Ministry of Health include: people with cancer; pregnant women and women in the postpartum period who have at least one risk factor for a severe course of COVID-19; patients over 12 years old with primary and secondary immunodeficiencies (receiving systemic immunosuppressive therapy, after organ transplantation, with oncohematological diseases) or concomitant diseases (type 1 and 2 diabetes mellitus in severe form, chronic kidney disease, cystic fibrosis, chronic obstructive pulmonary disease (COPD) , severe bronchial asthma); patients over 65 years old with obesity and chronic heart failure.
In September, an international group of experts from the World Health Organization (WHO) recommended treatment based on the use of monoclonal antibodies against coronavirus for some categories of patients with COVID-19. In their opinion, such treatment is primarily necessary for patients with a high risk of hospitalization with a severe form of the disease and those who have not developed their own immune response to coronavirus infection.
In its recommendations, WHO refers to a number of international studies on the effectiveness of the use of monoclonal antibodies. For example, according to a study published in The New England Journal of Medicine, administering the monoclonal antibodies kasirivimab and imdevimab to patients in the prehospital phase reduced the risk of hospitalization or death from COVID-19 by 71% compared to placebo.
This was due to a significant reduction in SARS-CoV-2 viral load during treatment. Kasirivimab and imdevimab are monoclonal antibodies that bind to the SARS-CoV-2 spike protein, blocking the virus’s ability to infect cells. The introduction of antibodies helps to form the patient’s immunity to covid infection in a very short time. Similar results were shown in a study of a single-component antibody sotrovimab – a reduction in the risk of hospitalization or death was 79% compared with placebo within 29 days after treatment.
The Ministry of Health of the Russian Federation in the new recommendations allowed the use of four neutralizing monoclonal antibodies for COVID-19 not registered in Russia: sotrovimab and regdanvimab (single-component drugs), bamlanivimab / etesevimab and kasirivimab / imdevimab (two-component). As noted in one of his interviews, the head of the Center. Gamaley Alexander Gunzburg, these antibodies are similar to those that protect against the virus and are in the plasma of those who have been ill, but they are genetically engineered outside the human body and in concentrated form. In this case, the patient is devoid of the risk of receiving proteins foreign to him, which can cause undesirable reactions in the body.
In Moscow, in September, they began to use the latest drugs from the group of monoclonal virus-neutralizing antibodies. However, now, in the conditions of a pandemic that has not subsided so far, experts express concern about the emergence of a shortage of these drugs, it follows from the appeal of Irina Borova. In its address to the Minister of Health, the Hello Association asks to draw attention to the need to create a strategic stock of innovative drugs for the treatment of COVID-19. In this regard, the patient organization asks to promptly take measures for planning and procuring in advance the necessary highly effective drugs to provide citizens with them.
“The problem with organizing procurement is that it is a very cumbersome mechanism. This is associated with planning purchases, conducting competitive procedures, organizing the supply of products. The drugs that are used to treat severe forms of covid are not cheap: the cost per package can be calculated But the use of such drugs is undoubtedly justified, since maintaining a person’s life during the acute phase of the disease will in any case cost more, “says Nikolay Bespalov, Development Director of RNC Pharma.