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Originator: CMO Messaging

From: CMO Messaging

Issue date: Originally issued on 27-Jan-2022 17:24:24. This version was issued on 27-Jan-2022 17:24:24

This alert has been issued to:
  • MHRA (Medicines) Drug Alerts (Various Recipients)
  • Other contacts
  • Independent Healthcare Providers (registered with CAS)
  • Clinical Commissioning Groups
  • NHS Foundation Trusts (England) - Medical Director
  • NHS Foundation Trusts (England) - Chief Executive
  • NHS Trusts (England) - Medical Director
  • CMO Urgent Messages - Non-NHS Recipients on Public Health Link
  • MHRA (Medicines) Drug Alerts - Non-NHS Recipients
  • Territorial CMOs in Northern Ireland, Scotland & Wales
  • Regional Directors of Public Health
  • Consultants in Communicable Diseases
  • CMO Urgent Messages - Recipients on Public Health Link
  • Director of Public Health
  • NHS Trusts (England) - Chief Executive

Action category: Action

Title: Antivirals and neutralising monoclonal antibodies in the treatment of COVID-19 in hospitalised patients

Broadcast content:
***27 January 2022: We have updated the Clinical Guide to rectify a broken link to the Remdesivir SmPC on page 3. We have also removed asterisk/footnotes on page 3 of the Clinical Guide and Appendix 1 of the Policy next to “corticosteroids”. No other changes have been made.***

***3 February 2022: Update - addition of date of SPS guidance and reference to Liverpool COVID-19 Drug Interaction Checker to footnote in Appendix 2.***

The published policy has been further updated (effective from 10 February 2022) to add an additional antiviral treatment option – PF-07321332 (may also be known as nirmatrelvir) plus ritonavir (Paxlovid) as a first-line treatment option for patients with hospital onset COVID infection. The intravenous antiviral remdesivir (Veklury) and the monoclonal antibody sotrovimab (Xevudy) remain available as alternative treatment options in this cohort.

Patients admitted due to COVID continue to have a range of treatment options under published UK policies, but will only be able to routinely access a monoclonal antibody treatment, casirivimab and imdevimab (Ronapreve), if genotyping confirms infection with a non-Omicron variant.  Patients ineligible for the casirivimab and imdevimab combination may be considered for entry into the RECOVERY trial, which is studying sotrovimab versus standard of care. Genotyping of all inpatients continues to be recommended to assist in treatment decisions and / or to support wider surveillance.

Additional information: This alert does not need to be cascaded to Primary Care.

Alert reference: CEM/CMO/2022/002


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