Patients with inflammatory diseases being treated with therapeutic monoclonal antibodies (mAbs) such as Infliximab may experience a significant increase in drug clearance during an active COVID-19 infection, Baysient LLC reports.

"We're seeing that patient clearance of mAbs during an active COVID infection increases between 50% - 77%, indicating a significant leap. This translates to a significantly shorter half-life," stated Diane Mould, PhD, FCP, FAAPS, Founder and Chief Scientific Officer of Baysient. "This is even true for patients who have COVID but are asymptomatic or exhibit few COVID symptoms."

"If a patient being treated with Infliximab tests positive for COVID, their drug clearance jumps quite a bit, meaning their body is not going to be able to retain the amount of drug needed to maintain its therapeutic effect," said Dr. Mould. Subtherapeutic mAb levels can result in treatment failure.

According to Baysient, when mAb clearance is high, low exposure to mAbs occurs more often and risks the patient forming anti-drug antibodies, reducing the drug's effectiveness and putting the patient at risk of treatment failure.

To preserve therapeutic drug levels and treatment efficacy, Baysient recommends that physicians prescribing mAbs implement therapeutic drug monitoring (TDM) into their practice, quickly adjusting the dose for patients who test positive for COVID.  Physicians should also consult with their patients about the need to test for COVID if they are exposed to it.

Time to Target, T3®, is a clinically proven web-based app physicians can use to easily determine the biological half-life of a drug and appropriate dose and dose interval to ensure steady-state drug concentrations. It can also be used once the COVID infection has resolved and the mAb clearance is returning to its pre-infection state to avoid supratherapeutic exposures.

TDM solutions like T3 are essential for improving the long-term efficacy of treatments for conditions like inflammatory bowel disease, rheumatoid arthritis, psoriatic arthritis, multiple sclerosis and more. Currently, T3 can be used for IV infliximab, SC infliximab, adalimumab, and vedolizumab.