Prophylactics, Therapeutics, and AstraZeneca — 3 Comments

  1. Most monoclonal antibodies — any of the zillion drugs advertised on TV whose generic name ends in “mab” — are indeed administered via IV infusion. In most cases this doesn’t need to be done in a hospital setting. The main concern is being prepared to deal with any serious reaction.

    A few mAbs can be administered subcutaneously, where they first enter the lymphatic system before working their way to the bloodstream. Rarely, a mAb might be administered intramuscularly.

    By the way, the likely reason for the popularity of creating “cocktails” of two monoclonal antibodies is to reduce the likelihood of selecting for a mAb-resistant strain of virus.

    • Thanks, Doug. Trials are still running (probably Phase I / II) to see how well some of the anti-coronavirus mAbs work via the subcutaneous route. One of the TWiV’ers mentioned in passing that there are tests with aerosol / inhaled delivery too; I haven’t seen reports of such.

      You will be happy to know, perhaps, that AstraZeneca had ADE in mind while developing AZD7442. The link above to mentions: “The reduced Fc receptor binding aims to minimize the risk of antibody-dependent enhancement of disease…”

    • Re: IV infusion. The protocol for AZ’s AZD7442 prophylactic trial has participants check into a hospital for two days: infusion first day, observation for 24 hours more. That’s after 28 days of some sort of observation (outpatient) preceding the infusion.

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