Updated 20th Dec 2021
Government announces a new scheme enabling clinically vulnerable people with Covid to receive early treatment at home.
If you are at highest risk – monoclonal antibody infusion
If you are at the highest risk of hospitalisation or death and are positive for Covid-19 you may be eligible to receive treatment without being admitted to hospital. The treatment you will receive is a monoclonal antibody treatment and you will be individually assessed by an expert clinician. The medicine will be given intravenously so you will have to travel to one of the new Covid Medicines Delivery Units to receive it and will then be monitored at home. Very soon, everyone in this group will receive a letter with more information and a home PCR test from the NHS to use should you develop symptoms. From the 16 December, if you test positive you should call up the Covid Medicines Delivery Unit or be referred via NHS 111/your GP and they will advise you on how to get your treatment. It is very important to note that these treatments must be given within 5 days, so if you are not contacted within 24 hours of a positive PCR test you should contact your doctor.
Neutralising monoclonal antibodies (nMABs) give your body the Covid-19 antibodies it needs to fight the disease. The antibodies will stick to the surface of the virus and stop Covid-19 from getting inside your cells, preventing you becoming seriously ill.
The advice on nMABs has changed from the 16 December because the currently available nMAB - Ronapreve, is unlikely to work against the omicron variant. Therefore, the nMAB which will be offered is Sotrovimab which is much more likely to be effective. On 20 December the Government announced the inclusion of a second Covid-19 antibody based treatment, Xevudy (sotrovimab), for those at highest risk of developing severe disease.
Approved earlier in December, Sotrovimab, is designed to be administered at early stages of infection to reduce the chances of people falling seriously ill from the disease. This medicine should be given within the first 5 days after being confirmed as positive with Covid-19 by PCR test, and is aimed at avoiding hospitalisation
This is the list of those with kidney disease considered to be at highest risk and eligible for monoclonal antibodies:
- Renal transplant recipients (including those with failed transplants within the past 12 months,) particularly those who:
- Received B cell depleting therapy within the past 12 months (including alemtuzumab, rituximab [anti-CD20], anti-thymocyte globulin)
- Have an additional substantial risk factor which would in isolation make them eligible for nMABs or oral antivirals
- Have not been vaccinated prior to transplantation
- Non-transplant patients who have received a comparable level of immunosuppression
- Patients with chronic kidney stage (CKD) 4 or 5 (an eGFR less than 30 ml/min/1.73m2) without immunosuppression
Please note that if you are in these groups (noted above) and are eligible an email or letter will be coming through soon. If you feel you may be eligible, but you haven’t received your letter, you can contact your GP or consultant to discuss whether you should be in the highest risk group. They will make an assessment of any conditions you may have, and if you should be eligible, they will issue you with further information on next steps.
We welcome the news of antibody and antiviral treatments for people with health conditions who get Covid. Some of you may not have a strong enough response to Covid-19 vaccinations, so this represents another opportunity to get protection from severe disease. However, if you do get Covid, treatment must be given within 5 days so you will need to report it quickly and the system really needs to work well to get treatments to you. It is notable that these are only available after you get Covid we hope in future they will be considered for use for those who are at high risk.
Antiviral treatment (Molnupiravir)
Molnupiravir is a new antiviral medicine. It should be available to anyone who fits the criteria for Covid-19 treatment above but is not suitable for treatment with Ronapreve. It is possible that Ronapreve may not be effective against the Omicron variant in which case molnupiravir would be given instead.
Molnupiravir is given as a five-day course of tablets which will be delivered to your home, provided that the course can be started within five days of the onset of symptoms. It is thought that molnupiravir is safe for kidney patients, but more research is urgently needed, especially for those with a very low eGFR.
If you’re not eligible for molnupiravir under this scheme, then you may be eligible to participate in the PANORAMIC study.
Kidney Care UK comment: “While this news is positive, we urge clear and immediate communications with busy healthcare professionals so that they will be able to advise anxious patients, many of whom have had problems with receiving their third primary dose. Now the treatments are available let’s make sure people can get them and that they know that they need to either ask or be referred quickly to gain any benefit from them.”
Transplant recipient Hal told us: “From my point of view, this means that I can get on with life. Patients need to be made aware that they can get these treatments if they get COVID, plus their risks and benefits, particularly with the Omicron variant’.
Panoramic study – anti-viral pill Molnupiravir
There is also a study where you may receive an antiviral medicine called Molnupiravir at home and which will look at how well it works. If you have Covid, you can sign up for it now here. You are eligible if you have Covid, are over 50 or have a health condition like chronic kidney disease. You will either be given the pill or usual NHS care. Treatment must be given within 5 days of symptoms starting or it will not be effective. While clinical trials have shown these medications worked well on unvaccinated people, it is not clear how well they work on a highly vaccinated population. You do not have to be vaccinated to take part in this study. If you receive a positive PCR test for COVID-19 and believe you may be eligible for the study, you are encouraged to enrol or to call the trial team on freephone number 08081 560017 to discuss your eligibility to enrol in the study.
Each country has a web page about the new treatments:
More information from NHS England: https://www.nhs.uk/conditions/coronavirus-covid-19/treatments-for-coronavirus/
This detailed commissioning information contains a list of all conditions who could receive monoclonal antibodies from next week: https://t.co/wqMAJAeITU
For the most up to date Coronavirus guidance go to our Coronavirus page.
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