Although there are already numerous vaccines against the coronavirus, no drug has yet been developed that can cure Covid-19. Could monoclonal antibodies be the breakthrough in treating Covid-19?
The development of vaccines against Covid-19 took place at breakneck speed and has led to several vaccines against the coronavirus being in use in Germany. However, there is little progress in the treatment of Covid-19 and only a few proven drugs. Cortisone preparations, oxygen treatments and the virus inhibitor remdesivir can alleviate symptoms and sometimes prevent severe courses, but the big breakthrough in the therapy of Covid-19 has not yet materialised. Could monoclonal antibodies be that breakthrough?
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What are monoclonal antibodies?
To protect our body against viruses and other pathogens, our immune system produces antibodies. These are proteins that prevent the respective pathogen from infecting and attacking our cells. Unlike our body’s own antibodies, monoclonal antibodies are made in the laboratory and are tailored to a single component of the pathogen. Monoclonal antibodies have a fast antiviral effect and can effectively neutralize viruses if given early. Monoclonal antibodies are often used in cancer therapy or in autoimmune diseases such as rheumatism.
With regard to Covid-19, monoclonal antibodies are said to take advantage of the weak point of the coronavirus – the spike protein. The cells of the coronavirus use this to dock onto receptors in the human respiratory tract and multiply there. Monoclonal antibodies are intended to render the spike protein harmless and thus prevent the spread of the coronavirus. This has already been achieved in laboratory tests. But what about the effectiveness in humans?
Are monoclonal antibodies effective against Covid-19?
However, what works in laboratory tests must first be tested on human subjects before it can be approved and widely used. The study situation on monoclonal antibodies as a remedy against the coronavirus or the disease Covid-19 is still very heterogeneous and ambiguous. Individual studies show a rapid drop in viral load and an alleviation of the course of the disease. Other studies show no effects. Numerous clinical studies are currently underway in which various monoclonal antibodies are being investigated, including the agents bamlanivimab, casirivimab or imdevimab. The suffix “ -mab ” stands for “ monoclonal antibodies ” ( = monoclonal antibodies) .
A disadvantage of monoclonal antibodies is that they are only effective in the early stages of Covid-19 disease. If someone has had the virus for weeks or even has to be ventilated, monoclonal antibodies are no longer effective. Furthermore, the use in immunocompromised patients could cause the development of so-called escape mutations . Such patients would then need to be treated with two different monoclonal antibody agents to prevent SARS-CoV-2 from mutating.
Are monoclonal antibodies approved for Covid-19 treatment?
Due to a lack of and ambiguous data, the RKI has so far advised against hasty approval of monoclonal antibodies for Covid 19 treatment . There have already been a few emergency approvals for such preparations in the USA. In Europe there are currently only two preparations (REGN-CoV2 and Regdanvimab) in the so-called ” rolling review ” process: The EMA is already examining a possible approval of these agents, which are still being tested in scientific studies at the same time. This ongoing review should enable approval to be granted as early as around 20 working days after the latest study results were announced.
