COVID-19 treatment: Antibody cocktail used to treat Donald Trump is helping patients in India; here's how

A Delhi hospital reported that two patients who were administered monoclonal antibodies showed remarkable recovery from the onset of symptoms of Covid-19 and were discharged within hours following the beginning of the treatment. Here’s how monoclonal antibodies work and why all eyes are on this therapy. Monoclonal antibodies made news as a treatment for Covid-19 when they were given to former US President Donald Trump last year after he tested positive for the disease on the US election campaign trail. It was described at the time as an “experimental antibody cocktail" that the New York Times reported was “one of the most promising candidates". Initial results, the New York Times said, had “suggested that they can reduce the level of the virus in the body and possibly shorten hospital stays — when they are given early in the course of infection". When US president received drug, it was an experimental therapy The former US President had a low-grade fever, nasal congestion and a cough during his illness. Trump was deemed to be at high-risk for COVID-19 due to his age and weight. He spent a few days in hospital and was reported to have required supplemental oxygen at least twice. Apart from the antibody cocktail, Trump was given the antiviral drug remdesivir, and the steroid dexamethasone. He reported in a little more than a week that he had recovered and was not a risk for spreading the infection. The former US President had a low-grade fever, nasal congestion and a cough during his illness. Trump was deemed to be at high-risk for Covid-19 due to his age and weight. He spent a few days in hospital and was reported to have required supplemental oxygen at least twice. Apart from the antibody cocktail, Trump was given the antiviral drug remdesivir, and the steroid dexamethasone. He reported in a little more than a week that he had recovered and was not a risk for spreading the infection. When Trump was down with Covid-19, monoclonal antibodies hadn’t yet received authorisation in US for Covid-19 patients, but Regeneron, whose drug the former US president was given, got the nod in November last year. What are monoclonal antibody therapies available in India? The same Regeneron drug got emergency authorisation in India from the Central Drugs Standards Control Organisation (CDSCO) in early May. The cocktail — composed of Casirivimab and Imdevimab — was cleared for use in mild to moderate cases of Covid-19 in high-risk patients. It has been launched in India in partnership with Cipla and costs Rs 59,750 for each patient dose of 1200mg (600 mg of Casirivimab and 600 mg of Imdevimab). Another drug, made by the US-based drugmaker Eli Lilly, too, has been cleared for use in India. But monoclonal antibody therapies are not recommended for severe cases of Covid-19 where the patient has been hospitalised and on oxygen support. So, what are monoclonal antibodies? When our body is exposed to a pathogen, which is a virus or bacteria that can cause disease, our immunity system produces antibodies to counter it. As the name suggests, monoclonal antibodies are clones of these antibodies that are created in a lab. They are targeted towards countering a specific antigen, which is nothing but a foreign element that the immune system recognises to be a threat, prompting the production of antibodies. The monoclonal antibodies used in the drug are artificially created in the laboratory and designed to bind to the spike protein of the novel coronavirus, which enables the virus to latch on to human cells. While their initial use for Covid-19 patients was on an experimental basis, antibody treatments are nothing new and have been used in Ebola and HIV patients.