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Infectious disease doctor addresses monoclonal antibody therapy

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Dr. Nagakrishnal  NachimuthuDr. Nagakrishnal NachimuthuBy Emily Banks Wooten
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“The best strategy is prevention which is through vaccination. In addition, continue to do masking and physical distancing.”

These are the words of Dr. Nagakrishnal Nachimuthu, an infectious disease physician at CHI St. Luke’s Health Memorial-Livingston.

Nachimuthu addressed the media during a press conference Monday to announce the opening of the state-supported Polk County Regional Infusion Center to help treat COVID-19 patients in East Texas.

“I would like to start off by mentioning that I am very appreciative of the initiative taken up by State of Texas in partnership with Polk County administration, hospital administration during this unprecedented time to set up this monoclonal antibody infusion for our community,” Nachimuthu said.

“Monoclonal antibody therapy is an outpatient therapy. It is indicated for patients with mild to moderate COVID-19 who are at risk of progression to severe disease. This should be given early in the disease within 10 days of start of symptoms. If a patient has COVID-19, they should approach their primary care physician/provider to see if they qualify for this treatment,” Nachimuthu said.

“The mechanism of action is that it reduces viral load by binding to the viral spikes thus preventing virus from attaching to the host cell and entering the host cell. Monoclonal antibody therapy thus helps reduce symptom severity and prevent hospitalization,” she said.

“Indications for monoclonal antibody therapy—based on criteria—most of the people will qualify. It includes age, high risk ethnicity groups, body mass index, chronic kidney disease, diabetes and other chronic health conditions. Exclusion criteria are new requirement of oxygen or increase in oxygen requirement from baseline, hospitalization and more than 10 days from symptom onset,” Nachimuthu said.

“Post exposure prophylaxis criteria also added as an indication for monoclonal antibody therapy. If a patient receives monoclonal antibody therapy they are advised to defer vaccination for 90 days as it hinders vaccine immune response,” she said.

“Adverse reactions such as rash, diarrhea or dizziness are mainly related to infusion and generally given as intravenous. Subcutaneous injections also available,” she said.

“This monoclonal antibody therapy strategy is good to prevent inpatient hospitalization and helps reduce some of the burden to our health care system but monoclonal antibody therapy does not replace and is not a substitute for vaccination,” Nachimuthu said.

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