Monoclonal Antibody Therapy at Montefiore

If you are at high risk for severe illness from COVID-19, you may qualify for either monoclonal antibody treatment (if you recently developed symptoms and tested positive), or prophylaxis (if you do not have COVID-19 but are moderate-to-severely immunocompromised).

Talk to your doctor to see if you are eligible for monoclonal antibody treatment or prophylaxis, based on your age, weight, the duration of your symptoms, and existing medical conditions.

What is monoclonal antibody therapy?
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Monoclonal Antibody

Monoclonal antibodies are created in a lab and function like naturally occurring antibodies, fighting infections before they cause too much damage. Studies show that when monoclonal antibodies are given intravenously to high risk people diagnosed early with COVID-19, it can prevent hospitalizations and even death.

Montefiore has been offering monoclonal antibody treatment to patients since December 2020 in our Montefiore Bronx Emergency Departments and a dedicated infusion suite. 

There are multiple monoclonal antibody therapies available, which have been authorized by the Food and Drug Administration. Montefiore only administers therapies which are proven to have activity against the major circulating variant.

How is monoclonal antibody therapy given?

The monoclonal antibody treatment is given intravenously, administered through a vein in the arm, within one hour. Patients are evaluated by a provider and monitored for any allergic reactions, which are extremely rare. The appointment takes two to three hours to complete; afterward, patients receive a follow-up phone call within a few days to ensure that they are improving. You must be within 7-10 days of symptom onset to qualify.

What are oral antiviral therapies against COVID-19?

There are two oral antivirals available under Emergency Use Authorization by the FDA. These are nirmatrelvir/ritonavir (Paxlovid) and Molnupiravir. The first is preferred because of greater effectiveness against COVID-19. Unlike monoclonal antibodies, these agents can be taken at home. Like, monoclonal antibodies, patients are eligible if they have recently developed COVID-19, have tested positive by PCR or antigen test, and have any high risk condition listed below. A prescription can be sent by your healthcare provider, or your provider can consult our program at the information listed below. You must be within five days of onset of your symptoms to qualify. 

Am I eligible for either oral antivirals or monoclonal antibody therapy?

To qualify, you must have tested positive for COVID-19 recently (by antigen or PCR test); have mild to moderate symptoms that are managed without oxygen support; and fall into one of the high risk categories below. These treatments are not for patients who are hospitalized for COVID-19.

You're eligible if you have any ONE of the following:

 

  • Older Age (for example, 55-65 years and up)
  • Chronic heart disease
  • COPD/chronic respiratory disease, including moderate asthma or emphysema
  • Diabetes (Type 1 or Type 2) on chronic medications
  • Chronic kidney disease
  • Immunosuppression due to a chronic medical condition (for example, active cancer, HIV, organ transplant, and others)
  • You're taking medicine that weakens your immune system
  • Pregnant (or recently delivered)
  • Neurodevelopmental, genetic, or metabolic disorder like Cerebral Palsy
  • Member of a racial or ethnic minority group at increased risk for severe Covid-19
  • Sickle Cell Disease
  • Medical technology dependent (trach, feeding tube, etc.)

 

12 to 17 years of age and at least 40 kg (88 pounds) with any of the following:

  • BMI greater than or equal to 85 percent of patients of the same age and gender
  • Regularly uses medical technology such as a ventilator or feeding tube
  • Have a developmental condition like cerebral palsy
  • Sickle cell disease
  • Congenital or acquired heart disease
  • Asthma/chronic respiratory problems requiring daily medication for control
Monoclonal Antibody Pre-Exposure Prophylaxis for Immunocompromised Patients

The U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for AstraZeneca’s Evusheld™, a combination of two monoclonal antibodies (tixagevimab and cilgavimab) designed to prevent COVID-19 infection in immunocompromised individuals who may not mount an adequate antibody response to COVID-19 vaccination.

How Is It Administered?

Evusheld is given as two intramuscular injections (300mg each) during the same visit at the Montefiore COVID-19 Monoclonal Antibody Infusion Program.

Who Is Eligible For Monoclonal Antibody Pre-Exposure Prophylaxis (Evusheld)

The FDA has given Emergency Use Authorization for Evusheld to be administered to adults and pediatric individuals (12 years of age and older weighing at least 88 pounds or 40 kg) who are not currently infected with SARS-CoV-2 and who have not had a known recent exposure to an individual with COVID-19, and

  • Who have moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments and may not mount an adequate immune response to COVID-19 vaccination
  • Or for whom vaccination with any available COVID-19 vaccine is not recommended due to a history of severe, life-threatening adverse reaction

Moderate to severe immune compromise includes:

  • Receiving active chemotherapy for any solid tumor malignancy
  • Hematological malignancy
  • Solid organ transplant and are taking immunosuppressants
  • Receipt of chimeric antigen receptor (CAR)-T-cell therapy within 2 years or maintained on immunosuppression
  • Hematopoietic cell transplant within past 2 years or maintained on immunosuppression or IgG replacement

Primary immunodeficiency

  • Advanced or untreated HIV infection (i.e., CD4 < 200)
  • Graft versus host disease receiving immunosuppression
  • Receiving T- or B- cell depleting drug
  • Anatomic or functional asplenia
  • Sickle cell anemia or thalassemia
  • Aplastic anemia
  • Neutropenia (ANC < 1000)
  • Myelodysplastic syndrome on therapy
  • Any other immunosuppressive conditions receiving immunotherapy (e.g., rheumatoid arthritis or lupus, on immunosuppressants)
How Can I Receive Evusheld?

After a discussion with your doctor about your eligibility, you or your doctor can place a referral by calling 1-844-444-CV19 option #3 or by emailing covidantibodies@montefiore.org (please include your contact information for call back). Doctors within the Montefiore system can email COVIDASP@montefiore.org to place referrals.

Please contact us at (844) 444-CV19 or CovidAntibodies@montefiore.org

How do I get access to COVID-19 Therapies?

To schedule an appointment, please call 1-844-444-CV19.

Location and Contact Information

1575 Blondell Ave, Suite 125, 2nd Floor
Bronx, NY 10461
718-405-8125
CovidAntibodies@montefiore.org
Business Hours: Monday - Friday 8:30am - 5:00pm

To schedule a consultation, please call 1-844-444-CV19.

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Priya Nori, MD

Longstanding inequities and chronic disease have led to high COVID-19 infection rates and significant risk of death in the Bronx. Now Bronx residents have a safe, evidence-based treatment that stops COVID-19 in its tracks and is preventing severe illness.

Priya Nori, MD
Infectious disease specialist and Director of the Antibiotic Stewardship Program at Montefiore, and Associate Professor of Medicine at Albert Einstein College of Medicine

Trusted Information Resources

Centers for Disease Control and Prevention

The leading national public health institute of the United States
 

NY.gov

For the latest COVID-19 guidelines and information from New York State 

World Health Organization

UN agency responsible for international public health