A limited number of immunocompromised patients in western Pennsylvania this week received a new monoclonal antibody cocktail meant to prevent COVID-19 before an exposure.
UPMC is one of several large health care providers across Pennsylvania to receive “very limited allotments” of Evusheld, the first monoclonal antibody authorized by the U.S. Food and Drug Administration, hospital officials said.
Allegheny Health Network also received 100 doses for patients in Pittsburgh and Erie. Evusheld is designed to prevent COVID-19 infections in people who might not otherwise generate a strong immune response to the disease.
“While these patients should absolutely still be vaccinated, it’s very exciting for us to now have an additional, long-acting antibody medication that serves as an extra layer of protection for some of our most vulnerable patients,” said Erin McCreary, an infectious diseases pharmacist and UPMC’s director of antimicrobial stewardship innovation.
The FDA issued an emergency use authorization in early December for Evusheld, which is made by AstraZeneca. It is approved for patients 12 years and older who weigh at least 88 pounds and have a moderate to severely compromised immune system, such as some cancer or transplant patients.
Though the COVID vaccine and Evusheld are both administered by intramuscular injections in patients’ arms, and both can help protect against COVID-19, McCreary said they work differently.
The vaccine stimulates the patient’s own immune system to create antibodies to protect against the virus. Evusheld gives patients a mix of two antibodies directly to provide protection that lasts between six months and one year.
UPMC received 456 doses of the drug this week — about a quarter of the total supply allocated to Pennsylvania by the federal government. It expects to get “limited shipments” of Evusheld in the coming weeks.
About 80,000 UPMC patients qualify to receive the treatment, 13,000 of whom have been deemed most vulnerable to COVID-19. With the current supply of Evusheld, hospital officials said they’ll be able to treat only about 3% of those most vulnerable patients.
UPMC began using a patient lottery on Wednesday to determine which patients will receive the treatment.
“First-come, first-served is not ethical,” said McCreary. “We truly feel the only way to do this right is to put all of those patients in a lottery and give certain weights for patients that are disproportionately affected by disease in order to structurally account for that, and then run a random number-generator lottery to determine which patients will be allocated the drug.”
UPMC will use the lottery system until it gets enough Evusheld to treat all eligible patients — which hospital officials warn is likely a long way off.
The announcement comes as COVID-19 cases continue to rise in Allegheny County and the highly transmissible omicron variant spreads. According to the Allegheny County Department of Health, new COVID cases went up by 1,980 from Dec. 29 to Dec. 30.
UPMC officials said full vaccination and booster shots are still the best way to protect against severe COVID-19 — even for patients who also are eligible for Evusheld. They also encourage mask-wearing and social distancing.
