NHS antibody treatment for immunosuppressed ‘mostly useless’ for omicron patients

An antibody treatment used by the NHS and given to immunosuppressed Covid patients “is not going to be of any help” against omicron, new research shows.

A treatment known as Ronapreve is a combination of two different monoclonal antibodies, called casirivimab and imdevimab.

In August, the MHRA said Ronapreve can be used to prevent infection, treat symptoms of serious infection and cut the likelihood of being admitted to hospital and authorise it for use.

By September, it was in use in NHS hospitals to treat severely ill patients who cannot make their own antibodies.

The MHRA said that the drug, developed by pharmaceutical firms Regeneron and Roche and previously known as REGN-Cov2, is given either by injection or infusion. It is designed to bind to the virus itself and prevent it from infecting human cells.

But the myriad mutations possessed by omicron have changed its shape, and it seems the antibodies can no longer stick to the virus, making them ineffective.

Prof Sir Martin Landray, Professor of Medicine and Epidemiology at the University of Oxford, leads the RECOVERY trial which found Ronapreve reduces the risk of death in immunosuppressed Covid patients by a fifth. These results from June also found the duration of hospital stay was four days shorter for patients taking the cocktail of two monoclonal antibodies.

But Prof Landray says the new studies which assessed the treatment’s impact against omicron show it is no longer of any use.

“The data suggest that many of the monoclonal neutralising antibodies have substantially weaker activity against the omicron variant,” he said.

“Critically, for the sickest patients – those admitted to hospital – the combination of casirivimab and imdevimab (which together make up the Ronapreve combination treatment) appear to be profoundly impacted.

“For the past few months, Ronapreve has been available for use in patients admitted to NHS hospitals. However, this treatment is not going to be of any help to the rapidly increasing number of patients affected by the omicron variant.”

Professor Adam Finn, a professor of paediatrics at the University of Bristol and head of the Bristol Children’s Vaccine Centre and a member of JCVI, said monoclonal antibodies are “mostly useless now”.

“There’s light at the end of the tunnel but quite a bit more darkness before we reach it.”

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