Maine CDC releases HAN recommending suspension of some mAb treatment options

On Friday January 7th, the Maine CDC released an updated Health Alert Notice (HAN) regarding Omicron's prevalence in Maine, and as such, the recommendation of the ME CDC that healthcare providers suspend the use of two monoclonal antibody therapies, bamlanivimab/etesevimab ("bam-ete") and casirivimab/imdevimab (REGEN-COV) for treatment of COVID-19.  As previously noted, sotrovimab, remains effective against the Omicron variant and should continue to be offered to patients meeting criteria.
  • Given this change, Maine CDC would encourage all mAb providers to continue or start offering sotrovimab IV infusion for treatment of mild-moderate COVID-19 for individuals at high risk for developing severe disease, though will note that supplies continue to be extremely constrained – e.g. last week Maine providers collectively submitted orders for 504 doses of sotrovimab, but Maine CDC received only 144 doses from the feds, and anticipate supply for the next few weeks will be similar. The feds have also noted that because demand for sotrovimab is so high nationally, there will not be any “swept” doses (from other states) available for the current time.
  • Maine CDC would also encourage mAb providers to consider the possibility of offering remdesivir in the outpatient setting; as noted in recent calls, results from a recent study showed good results in using remdesivir (X3D IV infusion) in decreasing progression to severe disease when given to outpatients at risk of severe disease within 7D of symptom onset.
  • In an effort to get a better sense of which sites are offering these two therapies, we'll be adding a question in this week's ordering form asking sites if you are offering and/or considering sotrovimab and remdesivir in your site, and will plan to use that info to update our list of mAb providers that we share w/ clinicians.
  • Please note that this HAN also includes information on distribution of the two new oral agents, Paxlovid & molnuiravir, including online links for info on which Walmart & Hannaford stores are receiving these meds. 
  • Given the extremely limited supply of all COVID therapies, Maine CDC will also be working over the coming week to provide guidance on how to consider prioritization of patients for COVID treatment. 
For now, ME CDC has recommended that clinicians consider the NIH COVID Treatment Guidelines Interim Statement on Patient Prioritization When There are Supply Constraints - attached here as well.

Lastly, please note that while this latest HANs is not yet there, all HANs are generally posted on ME CDC website:

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