In the fight against Covid-19, a new strategy has long been added to vaccines: prophylaxis for immuno-compromised people based on the combination of two monoclonals and capable of significantly reducing the risk of serious disease. About 20 thousand doses have been distributed so far, but the first 10 thousand will expire at the end of July and risk being largely unused in hospital pharmacies (for the other 10 thousand the deadline is December).
Too many vials are about to expire
The most virtuous in prescribing prophylaxis was Lombardy, but even here too many doses remained unused and an acceleration in the recall of fragile patients indicated by the Italian Medicines Agency (Aifa) is needed. This is why the Region is about to send a note to the General Managers, to avoid that the available vials are not used in time, as emerged from a meeting that involved Lombardy, part of the tour in 10 Regions promoted by Senior Italia FederAnziani in collaboration with AstraZeneca.
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What is the prophylaxis
“The combination of the two human monoclonal antibodies, tixagevimab and cilgavimab, represents an important option capable of preventing the disease in patients who have insufficiently responded to the vaccine“, explains Giuliano Rizzardini, Director of Infectious Diseases 1 at Luigi Sacco Hospital. di Milano: “A single dose, easily administered intramuscularly, determines a lasting protection for at least 6 months”. In the study published in the New England Journal of Medicinand, the combination reduced the risk of developing symptomatic Covid by 83%. “However – continues Rizzardini – so far its use in our country has been insufficient, despite the fact that there are many fragile and immunosuppressed patients and the numbers of the pandemic are not decreasing even in the summer period”.
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Various obstacles have so far limited this prophylaxis, as explained by Matteo Corradin, Director of the Operational Unit of the Hospital of the Lombardy Region: “One of the obstacles was the constraint constituted by a negative serological test, removed by Aifa also following our requests. More effort is now needed to administer the drug to patients requiring additional vaccine protection. We will send a note to the General Managers as soon as possible to urge them again to use the combination of monoclonals for Covid prophylaxis “.
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For whom is the prophylaxis
AIFA has decided to leave the decision on the treatment with this pharmacological option to the clinician, based on the evaluation of the individual patient. “In our country there are still too many people whose individual conditions do not allow a valid protective response to vaccination”, concludes Roberto Messina, Senior President of Italy FederAnziani: “It is estimated that there are over 150 thousand patients potentially eligible for treatment with the combination of monoclonals. These are, in particular, transplant patients, suffering from onco-haematological pathologies, in active chemotherapy treatment, or with immunosuppressive drugs for rheumatological or neurological pathologies, or affected by primary immunodeficiencies. We cannot leave them alone “.