Four thousand fragile patients to be protected from Covid and one thousand doses of prophylaxis with monoclonal antibodies expiring in a month. The numbers concern the Region of Sardinia, where there are still too few people who meet the criteria established by the drug agency and who, however, have not been able to benefit from this additional protection to the vaccine. For this reason, the Health Department of the Region, as in Lombardy, will send a note to all the centers. This is what emerged from the virtual meeting that involved Sardinia and which is part of the tour in 10 Regions, promoted by Senior Italia FederAnziani in collaboration with AstraZeneca.
Anti-Covid prophylaxis, unused doses are about to expire
by Dario Rubino
From those suffering from kidney disease to those taking anti CD-20 drugs
It is estimated that, in Italy, there are over 150 thousand citizens potentially eligible for treatment with the combination of monoclonals. These are, in particular, transplant patients, suffering from onco-haematological diseases, in active chemotherapy treatment, or with immunosuppressive drugs for diseases such as rheumatological or neurological, or affected by primary immunodeficiencies.
“In addition to kidney transplant patients, renal patients on immunosuppressive therapy could also be considered eligible for this prophylaxis”, explains Antonello Pani, Full Professor of Nephrology at the University of Cagliari and Director of the Department of Genitourinary Reproductive Diseases and Kidney Transplants at the ‘Brotzu Hospital of Cagliari.
Covid, preventive therapy with monoclonals is also effective against Omicron variants
by Dario Rubino
The response to the Covid vaccine in these patient populations is somewhat insufficient and lower than in the general population. Furthermore, in these two and a half years of the pandemic, some patients have not been able to be treated with certain immunosuppressive therapy schemes, for example with anti CD20 drugs (for multiple sclerosis, ed.), Because they affect the same ‘strand’ of immunity. which protects against Covid-19. “In these cases – says Pani – we have been forced to opt for more ‘mild’, less active immunosuppressive therapies, to reduce the probability of serious consequences in the event of Covid-19 infection. It could be considered to extend the use of these monoclonals also to these categories of frail patients. Today we have an effective weapon of prophylaxis before contact with the virus and these patients, who have evidence of little or no response to the vaccine, could be protected with the combination of two human monoclonal antibodies, thixagevimab and cilgavimab ”. The combination has in fact already been shown to reduce the risk of developing symptomatic Covid in fragile (immunosuppressed) subjects who are not vaccinated or with poor response to the vaccine by about 83% at six months. A single dose, administered intramuscularly, determines a lasting protection, for at least 6 months.
Don’t waste expiring doses
“We will send a circular as soon as possible to all the centers on the island to solicit the administration of the combination of monoclonal antibodies for the prophylaxis of Covid-19 to the categories of fragile patients indicated by AIFA”, said Mario Nieddu, Councilor for Hygiene, Health and Assistance social security of the Region of Sardinia: “It is essential to protect these citizens. We want to expand the number of accredited structures where it will be possible to access the drug “. “It is important that all Regions take action to protect the most fragile from Covid-19 who may not have developed an adequate response to vaccines which, in the event of infection, are at greater risk of negative outcomes”, concludes Roberto Messina: “There we hope that all doses will be used and that the health system purchases others to protect the more than 150 thousand vulnerable citizens ”.