Texas Offers New COVID-19 Treatments After Omicron Exhausts Monoclonal Antibody Supply
By Emma Freer

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As COVID-19 cases surge across the country, five regional infusion centers in Texas have exhausted their supply of sotrovimab, the only monoclonal antibody treatment effective against the omicron variant, the Texas Department of State Health Services (DSHS) announced on Dec. 27, 2021. But three recently authorized therapeutics are now available throughout the state and may be effective for certain COVID-19 patients.  

The federal government has allocated DSHS limited quantities of two oral medications – paxlovid and molnupiravir – for treatment of high-risk patients with mild to moderate COVID-19 infections who are at high risk of progression to severe COVID-19, including hospitalization and death. DSHS also has a limited supply of the monoclonal antibody treatment evusheld, which is a pre-exposure prophylaxis for COVID-19 in people who are immunocompromised and who are not expected to mount an adequate immune response to the COVID-19 vaccine.  

The U.S. Food and Drug Administration (FDA) has issued emergency use authorizations for all three medications, under which physicians must meet certain prescribing criteria. Due to the limited quantity of the medications, the National Institutions of Health (NIH) have also created guidelines for patient prioritization.  

The U.S. Department of Health and Human Services has created a COVID-19 public therapeutic locator. Physicians can enter in a city or ZIP code in the "Find in the dataset" search box to locate a nearby provider, including pharmacies. 

DSHS also has compiled a COVID-19 monoclonal antibody availability map, which shows treatment sites and therapeutic supply. 

Paxlovid treatment is authorized for children age 12 and older (weighing at least 40 kilograms or approximately 88 pounds) and adults, according to DSHS. It must start within five days of symptom onset and consists of three pills taken twice daily for five days. More information can be found in the FDA’s fact sheet and FAQ document.  
Molnupiravir treatment is authorized for adults 18 and older, according to DSHS. It must start within five days of symptom onset. Physicians should take special precautions when prescribing to women and men of child-bearing age as the medication was found to cause fetal harm in animal studies. More information can be found in the FDA’s fact sheet and FAQ document.  
Evusheld is authorized for people age 12 and older (weighing at least 40 kilograms or approximately 88 pounds) and is given as two intramuscular injections dosed every six months, according to DSHS. Evusheld is not a substitute for vaccination in individuals who have been recommended to be vaccinated, but it can be used to treat an individual with a history of a severe allergic reaction to a COVID-19 vaccine and who cannot complete the vaccination series. More information can be found in the FDA’s fact sheet and FAQ document
The federal government is not expected to ship additional courses of sotrovimab to Texas until later this month, according to DSHS. Other monoclonal antibody treatments have not been shown to be effective against the omicron variant, which now accounts for more than 90% of new cases in the state.  

Other monoclonal antibody treatments, including bamlanivimab/etesevimab and REGEN-COV, are not effective for omicron patients. DSHS asks physicians requesting these treatments to ensure there is laboratory evidence that the patient is not infected by this variant, which now accounts for more than 98% of new cases in the region, according to the Centers for Disease Control and Prevention.

Last Updated On

April 05, 2022

Originally Published On

December 29, 2021

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Emma Freer

Associate Editor

(512) 370-1383

Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

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