St. Anthony Summit Hospital changes which monoclonal antibody treatment it uses as other types prove not as effective against omicron |

St. Anthony Summit Hospital changes which monoclonal antibody treatment it uses as other types prove not as effective against omicron

The variant is now the dominant strain of COVID-19 in Colorado

A standalone clinic sits next to St. Anthony Summit Hospital in Frisco. The clinic allows for multiple simultaneous monoclonal antibody treatments while maintaining existing hospital bed capacity.
Brent Boyer/St. Anthony Summit Hospital

Within the past week, the omicron variant has taken over as the new dominant strain of the virus not only in the United States but also in Colorado.

Public health officials are still working to learn more about the variant — such as how easily it spreads, the severity of illness it causes or how well vaccines and other treatments work against it — but as more data and information come to light, it seems some of the monoclonal antibody treatments aren’t as effective as they are against the delta variant.

According to Aaron Parmet, infection prevention program manager for Centura Health, St. Anthony Summit Hospital has primarily used two types of the monoclonal antibody treatments: the bamlanivimab and etesevimab, which are used together, and the Regeneron. But the hospital is now changing its plans as the virus evolves.

Parmet explained that as the virus and disease changes, previously used treatments might no longer suffice. This is the case with some of the monoclonal antibody treatments.

In a perfect world, Parmet said public health officials could test each positive case of the virus to detect which strain a person has and then give them the monoclonal treatment that would be most effective for their case. But because sequencing takes weeks and the omicron variant is now the dominant strain, the types of treatments that are more effective on the delta variant are quickly becoming obsolete.

“The state sequencing is running weeks behind, and so we don’t have the opportunity to tailor to the individual patient as we would wish,” Parmet said. “There’s just no testing for that.”

Eventually, Parmet said the hospital will stop giving the two treatments altogether, but Centura spokesperson Brent Boyer said doctors will continue to use them on a case-by-case basis for now.

“If a visitor comes to us and is sick with COVID and maybe they just got into the state and (are) from an area where omicron is not yet prevalent — this is all just hypothetical — then it might make sense that a physician says … one of these other monoclonal therapies could be a good use for them,” Boyer said.

The treatment that is more effective on omicron is called sotrovimab. Now that there’s only one type that is effective on the variant, Parmet said demand is higher than before and that the criteria for being eligible is more specific.

“Instead of having a variety of monoclonal antibody products out there that we can give that are effective, there’s now one,” Parmet said. “Supply is very limited and the criteria for it are thus a little more restrictive in order to make sure that this treatment, the limited amounts of this resource, go to those who will benefit the most, and that’s the people that are at the highest risk.”

This type of treatment is reserved for those who are severely immunocompromised, those who are 65 or older and have an additional risk factor, or individuals who have two risk factors.

Monoclonal antibody therapies are used during the first few days of the onset of symptoms but only in cases where individuals were identified to have a higher chance of contracting a severe case of the virus. The point of this kind of treatment is to prevent hospitalizations.

Dr. Michael Roshon, who heads Centura Health’s research operations, said the treatment is most effective at the onset of symptoms. During this period, the virus is replicating, so the treatment is meant to stop or slow this process down. After 10 days, the virus is no longer replicating, which is when the treatment becomes less effective.

“When the (U.S. Food and Drug Administration) approved this, they only approved it for use in the first 10 days of symptoms, and we know, honestly, that it really works better faster,” Roshon said. “So if you can get it in the first three to five days is best, the first seven to 10 days is better, and then after 10 days, it has no utility at all.”

Though the hospital does have the sotrovimab treatment in stock, it’s in limited supply, and Parmet said Centura and the Summit County Public Health Department are advocating to the state for more doses.

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