Q&A: The ‘urgent need’ for outpatient COVID-19 treatments
In a recent analysis published in Clinical Infectious Diseases, researchers emphasized the “urgent need” for more accessible and effective outpatient treatments to stop the progression of COVID-19.
In addition to noting the many "repurposed" drugs tested against COVID-19 that “have had little or no benefit” against the disease, the authors mentioned that IV monoclonal antibody (mAb) cocktails have received emergency use authorization (EUA) from the FDA for patients with mild to moderate COVID-19.
One of those mAb cocktails was just authorized by the FDA to be administered subcutaneously.
“Easier to administer therapeutics including intramuscular and subcutaneous mAbs and oral antivirals are in clinical trials,” Myron Cohen, MD, director of the University of North Carolina Institute for Global Health and Infectious Diseases, and colleagues wrote. “Reliable, safe, effective COVID-19 treatment for early infection in the outpatient setting is of urgent and critical importance. Availability of such treatment should lead to reduced progression of COVID-19.”
We spoke with Cohen about the current state of outpatient treatment for COVID-19.
Healio: What are the current recommendations from the Infectious Diseases Society of America, WHO, etc., regarding outpatient treatment of COVID-19?
Cohen: Normative guidelines are dynamic and not always in agreement. In general, guidelines change to reflect new data. [Editor’s note: You can view the IDSA’s “living” guidelines for the treatment and management of COVID-19 here.]
Healio: Are there areas of guidance for outpatient COVID-19 treatment that are lacking?
Cohen: Guidelines for practicing health care workers (HCWs) are really a work in progress as new drugs and delivery routes receive EUAs and seek licensure.
Healio: How can these areas be improved upon?
Cohen: We need to communicate with the general population and all HCWs. Regeneron has started advertising it’s monoclonal antibody cocktail REGEN-COV on television, which is a great idea. I assume rapid testing will be advertised as well, soon.
Healio: How can access and equity issues related to outpatient treatment be addressed?
Cohen: As we go from a public health focus to an endemic treatment focus, we anticipate a groundswell of interest in “who to treat with what and how” before people become sick. A big challenge is selecting who to treat. What about people vaccinated who develop COVID-19? What about detection of asymptomatic infections?
Healio: What role do HCWs play in improving outpatient access? What about local health authorities?
Cohen: I anticipate treatment of early COVID-19 will become routine quickly. HCWs are waiting for easier testing and for drugs that can be rapidly and simply administered.