Pharmacists have an important role to play in making sure COVID-19 patients—or those trying to avoid infection—get monoclonal antibody treatments when appropriate.

The American Pharmacist Association says on its website, "Pharmacists in community-based settings can help increase patient awareness of these treatment options, assess for patient eligibility, and refer patients to their provider for treatment. Pharmacists are uniquely positioned to identify patients who may benefit from these underutilized and time-sensitive treatments through point-of-care COVID-19 testing, counseling, and/or clinical assessment. Pharmacists can help route patients to an appropriate provider and provide the location of an infusion clinic to initiate therapy."

In addition, some pharmacists, including those in long-term care settings or in pharmacies-accredited in-home infusion, might be able to procure monoclonal antibody therapies and work with staff trained to administer IV therapies, the association notes.

At a recent White House press briefing, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease, discussed use of monoclonal antibodies,  which he called "much underutilized," for treatment and prevention of SARS-CoV-2 infection and COVID-19 disease.

"For those not totally familiar with this, monoclonal antibody is an antibody that's produced by a single clone of B cells or a cell line and consists of identical antibody molecules that can actually be produced in the in-vitro situation in unlimited quantities," Dr. Fauci explained, adding that the word "monoclonal" means the treatment is effective "against the very specific part of the spike protein that can have a major effect in prevention and treatment."

Three anti-SARS-CoV-2 monoclonal antibody products currently have Emergency Use Authorization from the FDA for adults and children aged 12 years and older who weigh at least 88 pounds. The three include bamlanivimab plus etesevimab, casirivimab plus imdevimab, and sotrovimab. Each of these products targets the spike protein of SARS-CoV-2, according to Dr. Fauci.

In terms of treating SARS-CoV-2 infection, he explains that clinical trials have demonstrated that early treatment with anti–SARS-CoV-2 monoclonal antibodies can reduce the risk of COVID-19 hospitalization or death by 70% to 85%.

"It is important to emphasize that this must be done early in infection and not wait, of course, until a person is sick enough to be hospitalized," according to Dr. Fauci. "That's when you get the best effect. And again, being an underutilized intervention, we want people out there, including physicians, as well as potential patients, to realize the advantage of this very effective way of treating early infection."

Monoclonal antibodies are considered especially recommended for high-risk patients, including those older than age 65 years, with a suppressed immune system, or with certain medical conditions, including obesity, diabetes, heart disease, and certain lung diseases.

The products also can be used for prevention, Dr. Fauci advised. "And we know now that the FDA, just a couple of weeks ago, authorized the Regeneron monoclonal antibody for post-exposure prophylaxis, namely for the prevention of COVID-19 after someone has been exposed to a documented case of SARS-CoV-2," he said, adding that studies on pre-exposure prophylaxis are ongoing.

"So, the bottom line is: This is a very effective intervention for COVID-19. It is underutilized, and we recommend strongly that we utilize this to its fullest," Dr. Fauci concluded.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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