Houston Methodist has been a leader in successfully treating high-risk patients with monoclonal antibodies (mAB) for mild to moderate Covid-19 infection. Among the nation's largest providers of mAB therapy, Houston Methodist has infused nearly 4,000 patients since the FDA's Emergency Use Authorization (EUA) was issued. The hospital system was able to quickly ramp up its program once the EUA was granted by leveraging a number of resources through interdisciplinary collaboration.
As more hospitals begin to ramp up for treating Covid-19 with mAB therapy, Houston Methodist's example serves as a valuable model for other medical systems to establish or expand mAB treatment programs and improve patient access to this critical therapy. A commentary outlining the challenges, resources used and benchmarks of success published online March 29 in the New England Journal of Medicine Catalyst.
Houston Methodist drew upon its experience with clinical trials on other Covid-19 therapies and forged early partnerships with industry through the Houston Methodist Research Institute to conduct mAB clinical trials beginning early on in the pandemic. Doing so helped the hospital system overcome a number of obstacles to rapidly establish and scale up treatment clinics to bring mAB therapy to thousands of patients. Challenges included designing clinics using existing resources to separate Covid-19 positive patients from other hospitalized patients, establishing a referral stream that could treat large patient volumes and maintaining a sufficient drug supply to treat all patients.
Highlights included establishing six clinics in less than six weeks across the greater Houston area throughout Houston Methodist's system of hospitals; having an average of 1.2 days from referral to treatment; infusing more than 2,500 patients; and avoiding nearly 250 Covid-19-related hospitalizations. Some of these numbers have increased since the initial study period published in NEJM. Another mark of success, some patients have traveled as many as eight hours to receive mAB therapy at Houston Methodist. This also suggests a need for other healthcare systems to create or expand mAB infusion clinics to improve availability for those unable to travel.
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The commentary authors reflect the breadth of specialties involved in creating Houston Methodist's successful mAB treatment infrastructure and include Nursing Director Jennifer R. Berry, D.N.P., R.N.; Director of System Clinical Pharmacy Services Michael G. Liebl Pharm.D.; System Director of Research Operations Pauline H. Todd, M.B.A., B.S.N., R.N.; and Chief Nursing Officer Vicki Brownewell, M.S., R.N.
To read the study, titled "Rapid Operationalization of Covid-19 Monoclonal Antibody Infusion Clinics," visit https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0040.
Citation: Rapid Operationalization of Covid-19 Monoclonal Antibody Infusion Clinics. New England Journal of Medicine. (online March 29, 2021) Jennifer R. Berry, Michael G. Liebl, Pauline H. Todd and Vicki Brownewell; DOI: https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0040