The Covid–19 led to the need to hospitalize a very large number of patients. The resources of the National Health System and it was necessary to resort to containment measures never implemented before. While waiting for mass vaccination to avoid severe symptomatic disease and access to hospital, home care is the way forward to avoid situations similar to those of previous waves. Therefore, careful monitoring of patients becomes a priority to apply the therapies available for the different stages of the disease. Precisely in this regard, in recent weeks the panorama of monoclonal antibodies, a therapeutic option which brings family doctors closer to hospital specialists and which is also at the center of the European debate. In fact, in the last few days Stella Kyriakides, European Commissioner for Health and Food Safety, announced that theEuropean Union is aiming to authorize five possible new therapies against Covid-19: four monoclonal antibodies and an immunosuppressive drug. The vaccines in fact continue, but the virus will not disappear and we need to have safe and effective drugs.
The Project “The path of the patient with Covid-19 from traditional home care to linkage to care with specialized centers”, organized by SIMG, Italian Society of General Medicine and Primary Care, in collaboration with TURKISH BAGEL, Italian Society of Infectious and Tropical Diseases, with the unconditional contribution of GSK, has precisely the purpose of evaluating the options available for the correct approach to the patient with Covid-19. It starts from the clinical framework to arrive at the latest therapeutic options for the patient managed at home.
The project is divided into the drafting of a manual on home therapy of the patient with Covid-19 disease, including the initiation of therapy with, in fact, i monoclonal drugs. The initiative was presented in a national webinar in which the joint SIMG / SIMIT document was presented; This will be followed, on July 6-8-13-15, by training webinars for physicians at a macro-regional level, which will open to free consultation of the Manual by the medical profession.
“SIMG and SIMIT have committed themselves to a concise and practical document regarding local medicine for the home management of patients with Covid”, underlines Ignazio Grattagliano, SIMG Coordinator of the Puglia Region. “In the context of home care, monoclonal antibodies represent the most topical tool: they allow you to create the” linkage to care “between hospital and territory and for the first time allow local doctors (GPs, pediatricians, USCA doctors, medical guard) to be able to prescribe this category of drugs, this time intended for Covid, but which are often also used in the rheumatology, gastroenterology, oncology fields, etc “.
“Monoclonal antibodies are molecules that make it possible to defeat the virus”, explains Prof. Claudio Cricelli, President of SIMG. “They must be administered as soon as possible, when the diagnosis has just been made and when patients have vulnerable profiles: through these we can carry out prophylaxis on people exposed to the risk of serious infection. To date, just over 6 thousand doses have been administered, with very high efficacy rates. New generations of these increasingly sophisticated drugs are expected. The ideal place to administer this therapy is the patient’s home, who is not affected by the disease and must be protected. In the meantime, we must focus on early identification of the case and on the possibility of administering them easily, parenterally and not intravenously ”.
“The weapon of monoclonal antibodies will allow us to deal with great force with the continuation of the pandemic”, emphasizes Prof. Massimo Andreoni, Scientific Director of SIMIT. “Monoclonal antibodies must be administered early, for this we must have the decisive support of General Practitioners to use this fundamental and extremely effective weapon in the best possible way and as quickly as possible. The emergence of the variants makes a further problem within the use of monoclonals, because these could present resistance to the antibodies themselves. This is not the case with Delta, for which the studies completed so far demonstrate the effectiveness of the antibodies we are using. The great advantage of this new therapeutic strategy is that we can modify them and choose the most active ones in the variants that will gradually be generated. So we will be able to do an individualized therapy, with a monoclonal antibody directed not only against a specific variant, but also tailored to the individual patient “.
If vaccines can help stem the progression of the pandemic, we must remember that the virus will continue to be among us, to infect people and above all it will infect fragile subjects, those most at risk of an unfavorable evolution of the disease.