The mix of monoclonal antibodies that prevents Covid remains locked in the drawers

Less than 900 treatments administered in Italy compared to the 20 thousand doses delivered to the Regions. The drug Evusheld, composed of monoclonal antibodies tixagevimab and cilgavimab (able to bind to the Spike protein of Sars-CoV-2 in two different sites), authorized by the Aifa (Italian Medicines Agency) at the end of January. recommended for frail patients aged 12 and over who do not respond optimally to the Covid vaccine or who cannot be vaccinated. By binding to the Spike protein, the two antibodies prevent the virus from entering cells. But so far only 891 Italian patients have benefited from it.

What advantages does it offer?

The combination (produced by AstraZeneca) represents the first preventive prophylaxis treatment against Sars-CoV-2: from a study conducted on over 5 thousand people it emerged that reduces the risk of infection by 77%, with a protection of at least six months. After an average follow-up of 6.5 months, the reduction in disease risk stood at 83%. In laboratory studies the drug proved effective against the Omicron BA.2 sub-lineage (less against BA.1). It is administered with two consecutive intramuscular injectionscontaining 150 mg of tixagevimab and 150 mg of cilgavimab, respectively.

Which patients are candidates for treatment?

There are several groups that remain at risk of Covid, because they cannot get vaccinated or because they are immunocompromised – he explains Giovanni Di Perri, full professor of Infectious Diseases at the University of Turin -. These are in particular the transplant patients, with onco-haematological pathologies, in active chemotherapy treatment. In these fragile subjects, he warns Saverio Cinieri, president of the Italian Association of Medical Oncology, additional protection to the vaccine is required, even considering the low percentages of adherence to the fourth dose. In Italy there are about 150 thousand fragile patients who can receive treatment.

Why are the administrations less than expected?

From February to May 19, 891 treatments have been administered – he underlines Giovanna Scroccaro, of the Pharmaceutical, Prosthetics, Medical Devices Directorate of Veneto -. Low numbers and the reason also lies in the fact that the start of the administration coincided with the start of the fourth dose of the Covid vaccine. In addition, to access the treatment the patient must present a negative serological test, however – experts warn – the presence of an antibody titer does not ensure real protection from the virus. This is why, they explain, it is necessary to provide for a wider use. In patients vaccinated against Covid Evusheld should be administered at least 2 weeks after the last dose of the vaccine has been administered. To take stock, on the occasion of a national congress promoted by Federanziani, were oncologists and other experts. Federanziani herself organized a tour in 10 Regions to inform the population about the advantages of the drug, for which the European Medicines Agency (EMA) authorized its marketing on 25 March.

How many monoclonal antibodies have been used in Italy?

Overall, since March 2021, they have been 61,582 the prescriptions of monoclonal antibodies against Covid. Of these, 60,691 are therapies for patients with mild disease but at risk of progression, while 891 are pre-contagion prophylaxis.