{"id":9880,"date":"2020-11-15T09:44:13","date_gmt":"2020-11-15T14:44:13","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9880"},"modified":"2020-11-15T10:48:58","modified_gmt":"2020-11-15T15:48:58","slug":"bamlanivimab-hard-to-pronounce-even-harder-to-give","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/bamlanivimab-hard-to-pronounce-even-harder-to-give\/2020\/11\/15\/","title":{"rendered":"Bamlanivimab for COVID-19 — Hard to Pronounce, Even Harder to Give"},"content":{"rendered":"
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From Buffon and de S\u00e8ve\u2019s Quadrupeds (1754). This animal kind of looks like a bamlanivimab.<\/p><\/div>\n

The latest COVID-19 treatment made available under Emergency Use Authorization (EUA) is bamlanivimab<\/a>, a monoclonal antibody developed by Eli Lilly. For now, its use will be limited to outpatients who are at high risk for severe disease and\/or hospitalization.<\/p>\n

This EUA is based on the results of the phase 2 BLAZE-1 study<\/a>, in which the treatment reduced the need for hospitalization among outpatients — especially those deemed at high risk for poor COVID-19 outcomes. For this group, 3% of bamlanivimab versus 10% of placebo recipients required admission.<\/p>\n

And yes, you read that right — bamlanivimab<\/em>.<\/p>\n

The comedians sure had a field day with this tongue-twister, and boy it’s devilishly hard to say.<\/p>\n

But let me focus instead on the difficulty of actually giving this product to a stable, high-risk outpatient with COVID-19 — because remember, that’s the only way it’s going to help anyone.<\/p>\n

I’ve been ruminating over the challenges of implementing this treatment for a while, ever since research began on this class of drugs. Pharmacist Tim Gauthier’s outstanding summary amplified my concerns<\/a> when he wrote that the logistics of administration would be “considerable” — which could be the understatement of the year.<\/p>\n

Why so difficult? Let me list the ways:<\/p>\n