Introducing Ronapreve for patients hospitalised with COVID-19
Tutorial presented by Dr Jonathan Underwood, Infectious Diseases and Acute Medicines Consultant, CaVUHB.
In this tutorial, Jon introduces Ronapreve, including the evidence behind this new treatment, eligibility criteria, and how this drug might be adopted locally.
Ronapreve is a combination of two antibodies to the spike protein of SARS-CoV-2 virus; casirivimab and imdevimab. These antibodies are active against all the current circulating variants of SARS-CoV-2 including delta.
The RECOVERY study, currently available as a pre-print (linked below), found that for all participants there was no difference in 28-day mortality for patients who received Ronapreve versus usual care. However, when stratified by anti-S serology at baseline (seropositive at baseline or seronegative at baseline), there was a 6% absolute reduction in 28-day mortality in patients who were seronegative at baseline. This means that antibody testing at baseline is important for identifying patients who are going to benefit from Ronapreve.
The indications are outlined in the Updated Commissioning document from 04/11/2021 (also linked below), and include:
- Patients hospitalised specifically for the management of acute symptoms of COVID-19, and the infection is confirmed by PCR test
- AND Negative for baseline serum anti-spike (anti-S) antibodies against SARS-CoV-2
The commissioning document also outlines the use of Ronapreve in high-risk patients who acquire COVID in hospital. This is not covered in the video as it wasn’t an indication at the time of filming. Please see the commissioning document for further details.
The following operational pathway outlines the broad principles for adopting this drug:
- Has the patient been admitted specifically for acute COVID-19?
- Is the patient eligible for Ronapreve?
- Send antibody test to lab (put ‘for antibody therapy’ on test request)
- Antibody result likely the next ‘working’ day
- Is Ronapreve clinically indicated? Decision by treating consultant for seronegative patients only
- Liaise with pharmacy/sterile unit
- Administer to patient
Last updated 11/11/2021
Introducing Ronapreve for patients hospitalised with COVID-19
Tutorial presented by Dr Jonathan Underwood, Infectious Diseases and Acute Medicines Consultant, CaVUHB.
In this tutorial, Jon introduces Ronapreve, including the evidence behind this new treatment, eligibility criteria, and how this drug might be adopted locally.
Ronapreve is a combination of two antibodies to the spike protein of SARS-CoV-2 virus; casirivimab and imdevimab. These antibodies are active against all the current circulating variants of SARS-CoV-2 including delta.
The RECOVERY study, currently available as a pre-print (linked below), found that for all participants there was no difference in 28-day mortality for patients who received Ronapreve versus usual care. However, when stratified by anti-S serology at baseline (seropositive at baseline or seronegative at baseline), there was a 6% absolute reduction in 28-day mortality in patients who were seronegative at baseline. This means that antibody testing at baseline is important for identifying patients who are going to benefit from Ronapreve.
The indications are outlined in the Updated Commissioning document from 04/11/2021 (also linked below), and include:
- Patients hospitalised specifically for the management of acute symptoms of COVID-19, and the infection is confirmed by PCR test
- AND Negative for baseline serum anti-spike (anti-S) antibodies against SARS-CoV-2
The commissioning document also outlines the use of Ronapreve in high-risk patients who acquire COVID in hospital. This is not covered in the video as it wasn’t an indication at the time of filming. Please see the commissioning document for further details.
The following operational pathway outlines the broad principles for adopting this drug:
- Has the patient been admitted specifically for acute COVID-19?
- Is the patient eligible for Ronapreve?
- Send antibody test to lab (put ‘for antibody therapy’ on test request)
- Antibody result likely the next ‘working’ day
- Is Ronapreve clinically indicated? Decision by treating consultant for seronegative patients only
- Liaise with pharmacy/sterile unit
- Administer to patient
Last updated 11/11/2021
Resources
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Ronapreve Interim Clinical Commissioning Policy (updated document 4/11/2021)
Casirivimab and imdevimab for patients hospitalised due to COVID-19
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Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY)
A randomised, controlled, open-label, platform trial (pre-print)
