HEALTH: Hamilton hospital opens antibody therapy clinic,

Treatment aims to reduce hospitalization among high-risk patients

HAMILTON—St. Joseph’s Healthcare Hamilton is the first hospital in Ontario and one of the first in Canada to have a clinic providing monoclonal antibody therapy for COVID-19 patients.

The outpatient therapy clinic, which begins treatments Tuesday, is a pilot program aimed at reducing hospitalization among high-risk COVID-19 patients.

A monoclonal antibody is a lab-made protein that attaches to the spike protein of COVID-19 to stop the virus from infecting healthy cells, the health-care provider explained. The therapy could prevent mild cases of COVID from becoming more severe.

Like the COVID-19 vaccine, the therapy helps the body build antibodies to respond to the virus. But while the vaccine works if received at least two weeks before an infection, this therapy works even in the early days of COVID’s onset.

“In patients that are at high risk, a) the data suggest they will feel better a bit quicker, but b) the risk of serious outcomes will go down significantly,” said Dr. Zain Chagla, who’s running the Charlton Avenue clinic.

In Canada, two monoclonal antibody therapy drugs are approved to treat mild to moderate COVID-19 in high-risk patients: Sotrovimab and REGEN-COV. The latter, which St. Joe’s will be using for now, is the only one currently available. The U.S. has already bought millions of doses.

The Hamilton pilot is targeting patients who’ve tested positive for COVID and are 18 years and older and at “high-risk” of hospitalization. That includes immunocompromised patients and those who are unvaccinated and at risk of hospitalization.

The vaccine is still the best way to combat COVID-19, said Chagla. Most vaccinated people already have the needed antibodies, likely at a higher rate than what patients would get through the therapy. So, except for those whose health conditions cause a low immune response to the shot, vaccinated patients wouldn’t benefit much from the therapy. Some research suggests it might even be harmful, Chagla added.

But research has shown it works in people who don’t have antibodies, bringing hospitalization down by 71 per cent and reducing death by 70 per cent in high-risk COVID patients, the release said.

“That’s really why we’re offering it,” said the infectious disease specialist. “It’s not because we want to give unvaccinated people an alternative.”

A referral is required for the St. Joe’s clinic, which will be open daily and has capacity for up to 15 patients per day, he said.

Patients will receive the drug through an IV infusion for 30 minutes and wait another hour for monitoring before returning home to isolate. It’s a onedose therapy, Chagla said.

The program will inform research on the therapy’s impact while freeing up hospital beds, he added.

The clinic is among the first of its kind in Canada, St. Joe’s spokesperson Maria Hayes said in an email.

Patients can be referred to the clinic by their doctors, or recruited at the city’s COVID testing centres, starting at the Mohawk centre, Chagla said.

COVID-19 patients who are organ transplant recipients, receiving chemotherapy or taking biologic drugs are eligible even if they’re vaccinated. Those who are unvaccinated are only eligible if they’re over 50 years, or have a health condition such as hypertension, diabetes or obesity, among others.

“We’re going to get a lot more tools in the next six months to deal with COVID-19 … so it’s really important we have these processes in place,” Chagla said.

The “biggest barrier” right now is changing people’s behaviour to get tested early in their infection, whether they’re vaccinated or not, he added.

“We don’t want to see people in hospital that haven’t been tested and decided to stay at home,” Chagla said. “We could have actually intervened to prevent that outcome.”