Those at highest risk for severe COVID-19 often least likely to get
monoclonal antibodies, study finds
Date:
February 4, 2022
Source:
Harvard T.H. Chan School of Public Health
Summary:
People over age 65 at the highest risk for severe COVID-19 have
often been the least likely to receive monoclonal antibodies
(mAbs) -- a highly effective treatment for the disease -- both
across and within U.S.
states, according to new research.
FULL STORY ========================================================================== People over age 65 at the highest risk for severe COVID-19 have often
been the least likely to receive monoclonal antibodies (mAbs) -- a
highly effective treatment for the disease -- both across and within
U.S. states, according to new research co-authored by researchers from
Harvard T.H. Chan School of Public Health.
==========================================================================
The analysis will be published online February 4, 2022 in JAMA.
"Monoclonal antibodies should first go to patients at the highest risk of
death from COVID-19, but the opposite happened -- the healthiest patients
were the most likely to get treatment. Unfortunately, our federal and
state system for distributing these drugs has failed our most vulnerable patients," said Michael Barnett, assistant professor of health policy
and management at Harvard Chan School and lead author of the study.
Monoclonal antibodies are very effective at treating mild to moderate
COVID-19 infection among non-hospitalized patients. But during the
pandemic, mAbs have been in short supply. Federal guidelines prioritize patients at higher risk of being hospitalized or dying from COVID-19,
including older people and those with chronic conditions.
The researchers wanted to learn how the limited supply of mAb therapy
was allocated to patients at highest risk for severe disease. They
looked at data from more than 1.9 million Medicare beneficiaries who
had been diagnosed with COVID-19 between November 2020 and August 2021,
and compared rates of receiving mAbs by age, sex, race and ethnicity,
region, and number of chronic conditions.
They found that, among Medicare beneficiaries who weren't hospitalized
or who didn't pass away within seven days of their diagnosis, only 7.2% received mAb therapy. The likelihood of receiving mAbs was higher among
those with fewer chronic conditions -- 23.2% of those with no chronic conditions received mAbs, versus 6.3%, 6.0%, and 4.7% of those with 1-3,
4-5, and 6 or more chronic conditions, respectively. The researchers
also found that Blacks were less likely to receive mAbs than whites --
6.2% versus 7.4%.
In addition, there were significant differences among states when it came
to mAb treatment. For example, Rhode Island and Louisiana administered
mAbs to the highest proportion of non-hospitalized patients with COVID-19 (24.9% and 21.2%), while Alaska and Washington administered the lowest proportion (1.1% and 0.7%). Southern states had the highest rates of
mAb therapy (10.6% of beneficiaries), while states in the West had the
lowest rates (2.9%).
Speculating as to why mAb therapy often failed to reach the highest-risk
COVID- 19 patients, the researchers said it's possible that higher-risk patients may have had difficulty navigating the multiple steps needed
to receive mAbs, from receiving a timely diagnosis to referral and
scheduling an infusion within 10 days. As for differences among states,
they suggested that mAb supply may have been low or less used by
clinicians in some regions of the U.S.
"We need new approaches to prevent these inequities from happening again
with newer treatments on the horizon," said Barnett.
Other Harvard Chan School co-authors included Ellen Meara, Arnold Epstein,
and E. John Orav.
Funding for the study came from the National Institute on Aging (grant
K23 AG058806) and the Agency for Healthcare Research and Quality (award
U19 HS024075).
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Harvard_T.H._Chan_School_of_Public_Health. Note: Content may be edited
for style and length.
========================================================================== Journal Reference:
1. Caroline L. Behr, Karen E. Joynt Maddox, Ellen Meara, Arnold
M. Epstein,
E. John Orav, Michael L. Barnett. Anti-SARS-CoV-2 Monoclonal
Antibody Distribution to High-risk Medicare Beneficiaries,
2020-2021. JAMA, Feb.
4, 2022 DOI: 10.1001/jama.2022.1243 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/02/220204113330.htm
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