Carilion Clinic doctor explains monoclonal antibody treatments

Published: Sep. 2, 2021 at 3:14 PM EDT
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ROANOKE, Va. (WDBJ) - More patients in southwest Virginia are seeking monoclonal antibody infusion treatments as the COVID-19 pandemic continues.

We invited Dr. Dorothy Garner, Interim Chief of Infectious Diseases at Carilion Clinic, to join us on the WDBJ7+ Digital News Desk to explain the treatment.

What are monoclonal antibody treatments?

According to Dr. Garner, these infusion treatments are therapeutics which are designed to target the spike proteins on the surface of the coronavirus that causes COVID-19.

“The spike protein is the mechanism by which the virus attaches to your body’s cells, for instance, your lung cells,” Dr. Garner explained. “And by the monoclonal antibody binding to that spike protein, it’s not able to attach and your body can clear the virus more rapidly and therefore you won’t become as ill with the infection.”

The technology used for this type of treatment was established in 1985, Garner said. But the FDA granted Emergency Use Authorization to use this treatment specifically for COVID-19 in November of 2020.

Since then, Dr. Garner says additional monoclonal antibodies have been approved. More than 600,000 people in the United States have received the treatment, with about 400 of of those administered by Carilion Clinic.

Who is eligible for the treatment?

Dr. Garner says certain criteria must be met before someone becomes eligible for the treatment. They must first test positive for the virus and be symptomatic for less than 10 days. You must also be at increased risk for more serious disease, such as: being 65 years old and above, having a BMI over 25 or being overweight, having hypertension, heart disease, diabetes, lung or kidney disease or being immunocompromised.

On August 1, the eligibility was expanded to include high risk individuals who came into contact with someone who tested positive for COVID-19 and is not vaccinated, got a vaccine less than two weeks ago, or who has one of the conditions that make them unlikely to develop a full response to a vaccine.

How effective is it?

According to Dr. Garner, the clinical trials that brought these therapies into the Emergency Use Authorization showed a 70 to 85 percent reduction in hospitalization and death if given early in the infection period to those in the high risk category.

How can you get the treatment? How much does it cost?

According to Dr. Garner, the most important step is to get diagnosed early. If you think you’ve developed COVID symptoms, you want to seek medical care to get diagnosed as early as possible. The treatment, she said, works better when given early in the infection and she recommended reaching out to your doctor as soon as symptoms develop.

“If you get it in the first two to three days of symptoms,” she said, “you will have a better response.”

Once you confirm with a positive test, you will need to reach out to your primary care doctor who will get you scheduled for the infusion treatment. You must have a doctor’s referral to get the treatment. Those without a primary care doctor can call Carilion Direct (800-765-3506 or 540-981-7000) for more information. Before the treatment is administered, however, each patient must first review a fact sheet about the treatment.

The treatment is administered just once, with an infusion lasting 30 minutes. Patients are then monitored for one hour afterward to be sure they don’t develop side effects. Dr. Garner said there is always a chance for an allergic reaction, but side effects from the treatment are rare. She said there have been just a few cases of fever and chills among Carilion’s patients, which staff manage with Tylenol. The infusion center at 1 South and the center in the New River Valley Center have rapid response teams which can respond to assist in the event of an allergic reaction.

After treatment, Dr. Garner said unvaccinated patients should wait to get vaccinated against COVID-19 for 90 days so that the vaccine will be able to initiate a strong immune response.

As for the cost, Dr. Garner said for most patients, it requires no out of pocket payments.

“The federal government felt so strongly this would save lives, it has provided the current monoclonal antibody that Carilion is providing for free,” Garner said.

The cost of infusion, use of the center, staff, tubing and the IV fluid the treatment is mixed in costs about $300. Dr. Garner said insurance is charged and Medicare has been covering and supporting this treatment.

Carilion is offering the treatment at three locations:

  • Carilion New River Valley Medical Center, 2900 Lamb Circle, Entrance 10, Christiansburg, VA 24073
  • Carilion Roanoke Memorial Hospital, 1906 Belleview Avenue SE, Roanoke, VA 24014 (1 South or 10 South After Hours)
  • Postal Drive Infusion Center, 4064 Postal Drive, Roanoke, VA 24018

What’s the current demand like? How is Carilion meeting that demand?

Dr. Garner said there is currently a significant increase in demand for this treatment.

“I think it took a while for people to learn about this and one of the reasons we’re trying to let people know is if you get the infusion early after you get COVID infection, you’re less likely to need to go to the hospital,” she explained. “And our hospitals are really being taxed right now as you see on the news lately with the numbers of COVID infections and the number of people requiring hospital management.”

Carilion recently reopened the infusion center on Postal Drive in Roanoke which it has closed during the summer when COVID cases had decreased. Dr. Garner said Carilion also expanded the hours of the infusion center at the hospital, which will now include weekend appointments.

Administration is working to hire more people and expand hours even more to make more appointments available at the Postal Drive site, which Garner said will be the easiest one to expand. She said Carilion is also reaching out to regional partners who can assist, though at this point, Carilion is providing the majority of the infusions in our area.

“So we are working hard to meet the demand,” Garner said.

For more information, visit Carilion’s website.

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