Covid-19: severely immunocompromised patients desperately awaiting protective treatment

From February 2020, with the outbreak of the pandemic, we felt the wind of the ball pass. Since then, we have been living in cloisters, we are voluntary lepers. In danger of death, most of us experience great psychological difficulties which are not taken care of ”, testifies Catherine (the first name has been changed). Seven years ago, the 63-year-old woman received a kidney transplant. She received three doses of the Covid-19 vaccine this year. But she hasn’t developed any protective antibodies, because of the treatment she’s taking to prevent transplant rejection: it suppresses her immune system.

Above all, Catherine does not understand. On August 4, the High Authority for Health (HAS) authorized in “Early access” preventive treatment for all those who, like her, suffer from severe immunosuppression and do not respond to the vaccine. These patients, in fact, have a sword of Damocles over their heads. Kidney transplant recipients, for example, have a 15% risk of dying from Covid-19 once infected. That is “A higher risk than that of residents in nursing homes”, notes Catherine.

The protective treatment they could benefit from is a cocktail of monoclonal antibodies which, as a preventive measure, must be administered every month in the hospital by subcutaneous injection or by intravenous infusion. Marketed by the Roche-Regeneron group, this treatment, Ronapreve, combines two antibodies (casirivimab and imdevimab) that specifically target the spike protein of the SARS-CoV-2 virus, thus neutralizing its ability to enter human cells. It is the same treatment that was administered to US President Donald Trump affected by Covid-19 in October 2020.


What Catherine does not understand is why this preventive treatment is refused to her, despite her repeated request to the team that follows her, at the Pitié-Salpêtrière hospital (Assistance publique-Hôpitaux de Paris, AP- HP), in Paris. Especially since the National Medicines Safety Agency (ANSM), in a notice of July 30, “Attests to the strong presumption of efficacy and safety of the drug Ronapreve” in prevention of severe forms of Covid-19, before or after contact with an infected person, in adults and children 12 years and older “Not having developed, due to their immunosuppression, a sufficient vaccine response to a complete vaccination schedule”.

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In France, the number of patients concerned is estimated at 57,500, or, according to the HAS, a quarter of some 230,000 severely immunocompromised people identified by the vaccine strategy orientation council. Among them, patients treated for blood cancer, people with certain genetic deficits, chronic dialysis patients, etc., and around 12,000 kidney transplant recipients.

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