Insights on operationalizing COVID-19 monoclonal antibody treatment

PITTSBURGH, March 26, 2021 – As evidence mounts supporting the use of monoclonal antibody treatment to reduce hospitalizations and deaths from COVID-19, UPMC and University of Pittsburgh School of Medicine physician-scientists are sharing the health system’s experience administering the life-saving medication.

In a report published today in the scientific journal

Open Forum Infectious Diseases

, the UPMC/Pitt team shares how it quickly established the largest and most equitable distribution network for COVID-19 monoclonal antibody infusions across Pennsylvania. The team today also reported preliminary results confirming the treatment reduced likelihood of hospitalization and death in UPMC patients who received it.

“When administered soon after infection, this treatment can help certain people fight the virus and keep them from progressing to serious illness and death,” said Ryan Bariola, M.D., associate professor in Pitt’s Division of Infectious Diseases and director of the UPMC Community Hospital Antimicrobial Stewardship Efforts (CHASE) Program. “But administering these infusions comes with logistical challenges, so many health care providers opt not to offer the treatment. UPMC overcame these challenges, and we’re dedicated to sharing what we learned with other medical centers, clinicians and the public.”

Monoclonal–“mono” means “one” and “clonal” means “copy”–antibodies are a type of medication that seeks the COVID-19 virus in a person’s body and blocks it from infecting their cells and replicating. Since late 2020, the U.S. Food & Drug Administration has granted Emergency Use Authorization (EUA) to three monoclonal antibody treatments–one from Regeneron and two from Eli Lilly–which are given through a one-time IV infusion. This is the same type of emergency authorization given to the COVID-19 vaccines being administered in the U.S.

This therapy is most helpful when given early, especially within 10 days of infection in people at highest risk of complications from COVID-19.

The U.S. supply of monoclonal antibodies is taxpayer-funded and given without charge to the institutions that administer it. Preparing for high patient demand, UPMC created a weighted lottery to ensure fair allocation of its supply. However, demand was never high enough to trigger use of the lottery.

“This lower use surprised us, and we’re still debating why demand was less than expected,” said co-author Donald M. Yealy, M.D., UPMC chief medical officer and professor and chair of Pitt’s Department of Emergency Medicine. “It likely had to do with so few health care providers investing in the infrastructure, staff and processes needed to administer the drug. This created lower awareness among both patients and clinicians about the life-saving benefits of monoclonal antibodies.”

Initially, eligibility was limited to patients 65 years or older, or to those with a body mass index of at least 35 because those were the people studies had indicated were most likely to benefit. UPMC has since expanded eligibility to younger people with certain medical conditions that place them at higher risk for complications from COVID-19, including children, in compliance with the EUA.

To date, UPMC has treated more than 1,000 patients with monoclonal antibodies at 16 sites across the communities it serves in Pennsylvania and New York. It also provides home infusion services when needed. UPMC ensures that all proper infection prevention protocols are followed, and specifically prevents COVID-19 patients from mixing with other patients at the infusion centers.

“Monoclonal antibodies are a crucial part of the COVID-19 treatment spectrum, bridging the gap between preventive measures–such as masks, social distancing and vaccination–and the various therapies for hospitalized COVID-19 patients,” said senior author Mark Schmidhofer, M.D., professor of medicine at Pitt and medical director of UPMC’s Coronary Intensive Care Unit. “It’s a potentially life-saving option and can keep people out of the hospital if prevention fails.”

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Patients and providers can find out more about monoclonal antibody treatment at UPMC by visiting upmc.com/AntibodyTreatment or calling 866-804-5251.

Additional authors of this research are Erin McCreary, Pharm.D., Tina Khadem, Pharm.D., Graham Snyder, M.D., M.S., Richard Wadas, M.D., David A. Nace, M.D., M.P.H., and Douglas B. White, M.D., M.A.S., all of Pitt and UPMC.

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About UPMC

A $23 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates 92,000 employees, 40 hospitals, 700 doctors’ offices and outpatient sites, and a 4 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.4 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $800 million in federal, state, and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside among the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.??? ??????

About the University of Pittsburgh School of Medicine

As one of the nation’s leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support.

Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region’s economy. For more information about the School of Medicine, see

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