| Common Brands | REGEN-COV, Ronapreve |
|---|---|
|
Drug Class |
Monoclonal Antibody Combination |
|
Controlled Substance Classification |
Not a controlled medication |
|
Generic Status |
No, brand-name only |
|
Availability |
Prescription only, available under emergency use authorization or approved status in select countries |
Casirivimab and Imdevimab (trade name: REGEN-COV) are two monoclonal antibodies developed by Regeneron Pharmaceuticals for COVID-19 treatment. Two monoclonal antibodies used in a combination regimen as a treatment for mild to moderate COVID-19 among patients who are at a high risk of disease progression to severe, hospitalization, or death. The U.S. issued EUA to Casirivimab and Imdevimab..
These include direct targeting and neutralization of the spike protein of the virus that causes COVID-19; specifically SARS-CoV-2 through blocking of the virus so that it cannot enter into human cells and inhibition of the virus’s replication cycle. It reduces viral load, the duration of the symptoms, and the possibility of the risk of more severe disease, hospitalizations, and death in persons at higher risk for having their condition progress to the more severe form of COVID-19.
Casirivimab and Imdevimab use in Treatment of COVID-19: This medicine is used for the treatment of mild to moderate COVID-19 in patients at the risk of developing severe illness, hospitalization, or death. Such individuals comprise those with comorbid conditions, elderly, and immunocompromised ones.
For Post-Exposure Prophylaxis (Prevention): The combination therapy can also be used as a preventive treatment (prophylaxis) for people who have been exposed to COVID-19 and are at high risk of developing severe disease. In this case, the antibodies help prevent infection or reduce the severity of illness.
The treatment should be given as early as possible after a positive test for COVID-19 or after exposure to the virus because the therapy is best administered early in the course of illness.
Both casirivimab and imdevimab work by binding to the spike protein of the SARS-CoV-2 virus, which is the main mechanism the virus uses to enter human cells. Here’s how they work together:
Binding to Spike Protein Casirivimab and Imdevimab bind to distinct regions on the spike protein of SARS-CoV-2 virus. Spike protein represents that part of the virus through which the virus would attach to human cells to get inside these cells through their ACE2 receptor to start infection process.
By binding to the spike protein, these monoclonal antibodies prevent the virus from attaching to ACE2 receptors on human cells. It therefore prevents entry of the virus into cells, hence its replication mechanism is blocked.
Neutralization of the Virus: When the antibodies bind to the spike protein, they neutralize the virus, meaning it can no longer cause infection of cells and, therefore, cannot spread within the body.
Synergistic Effect: By employing two antibodies targeting different parts of the spike protein, this combination therapy helps prevent the virus from evading the immune response. This approach is effective because it is less likely that the virus will develop resistance to both antibodies at the same time.
In summary, Casirivimab and Imdevimab decrease the viral load in the body, and the immune system mounts a better response to the infection, and the severity of the disease is decreased.
Although Casirivimab and Imdevimab are usually well tolerated, they may cause side effects, mainly during the infusion process. Common side effects include the following:
Infusion-related Reactions: These are fever, chills, nausea, headaches, and low blood pressure. Such reactions can occur during or shortly after the infusion.
Rash or Skin Reactions: Some patients develop rashes or other skin reactions.
Gastrointestinal Symptoms: Nausea, vomiting, and diarrhea have been reported in some patients.
Allergic Reactions: In some instances, one may experience severe allergic reaction known as anaphylaxis, which can take the form of difficulty in breathing, swelling of face or throat, and heavy heartbeat. Medical attention ought to be sought immediately on experiencing such symptoms.
Other Side Effects: Some feel fatigue, dizziness and muscle aches. Generally, most side effects appear mild and disappear once infusions are over.
Infusion-related Reactions: Casirivimab and Imdevimab should be given with caution in patients who have had prior allergic reactions to monoclonal antibodies. Patients must be monitored closely during and after the infusion for any signs of infusion-related reactions.
Efficacy against Variants: Though this combination has been effective in the native strain of SARS-CoV-2, in newer variants of concern (such as the Delta and Omicron variants), its effectiveness could be hampered. These studies are ongoing to study the activities of these antibodies against emergent variants.
Pregnancy and Breastfeeding: The use of Casirivimab and Imdevimab during pregnancy and breastfeeding has not been adequately demonstrated. Therefore, the medicine should only be administered with caution where the potential benefit justifies the potential risks. Administration to pregnant and breastfeeding women should be given under medical supervision.
No Replacement for Vaccination: Casirivimab and Imdevimab are no substitute for vaccination against COVID-19. Vaccination remains the ultimate long-term approach to avoiding COVID-19.
Casirivimab and Imdevimab are administered in combination via intravenous infusion. The recommended dosage of this combination therapy is as follows:
Casirivimab: 600 mg
Imdevimab: 600 mg
These are usually given together as a single infusion, slowly infused into the bloodstream over a period of 30 to 60 minutes. Infusions are usually done in a healthcare setting under the supervision of a medical professional.
Medical personnel may also take steps to manage and monitor the patient in cases of a severe allergic reaction or other infusion-related reactions. It is recommended that patients be observed for at least one hour after receiving the infusion.
Casirivimab and Imdevimab are generally administered as a single dose of 600 mg IV infusion of each antibody. The dose may be redosed in some cases such as re-infection or worsening of symptoms. In order to have the best results, the treatment must be initiated as soon as possible in the course of illness or exposure.
Casirivimab and Imdevimab are being distributed for the treatment of COVID-19 under the EUA. The medication has to be prescribed and usually used in patients that have a high risk for serious disease or hospitalization. The infusion is a clinic setting, and follow-up with the patient about any possible side effects needs to occur during and immediately after infusion.
They are monoclonal antibodies used together to treat and prevent COVID-19 by targeting the SARS-CoV-2 virus.
They bind to different parts of the coronavirus spike protein, blocking the virus from entering human cells and reducing viral replication.
The combination is marketed under the brand name REGEN-COV or Ronapreve in some regions.
They are used for treatment of mild to moderate COVID-19 in high-risk patients and for post-exposure prophylaxis.
Administration can be via intravenous infusion or subcutaneous injection.
Patients with confirmed COVID-19 at high risk of severe disease or individuals exposed to COVID-19 in household or similar close-contact settings.
Side effects include infusion/injection site reactions, allergic reactions, fever, chills, and nausea.
They are generally not recommended for patients hospitalized and requiring high-flow oxygen or mechanical ventilation.
Their effectiveness can vary with different variants; some variants have shown resistance, so use depends on local circulating strains.
Yes, they can be used for post-exposure prophylaxis in certain cases to prevent infection.
Ideally within 10 days of symptom onset for maximum effectiveness.
No major interactions are known but inform your healthcare provider about all medications.
Safety and efficacy in children vary by age and region; consult a healthcare provider.
No, they are not a substitute for vaccination but complement vaccination efforts as treatment or prevention.
Evaluate allergies, immune status, and monitor during and after administration for adverse reactions.
Protection duration is limited and meant for immediate post-exposure period.
Coverage varies but many healthcare systems provide access during the pandemic.
Long-term risks are currently unknown, ongoing monitoring continues.
They were developed by Regeneron using genetically engineered mice and human B-cells to produce antibodies.
Through healthcare providers, official health agencies like the FDA, CDC, or WHO websites.
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