Bebtelovimab vs Paxlovid: Wondering if anyone... - CLL Support

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Bebtelovimab vs Paxlovid

Davidcara profile image
18 Replies

Wondering if anyone has experience with Bebtelovimab? Son has been isolating in his room with covid for last 8 days. He is feeling better but, still positive as of yesterday.

Yesterday, wife was feeling terrible, and tested positive for covid. Feeling much better today. Isolating in back bedroom.

I contacted my oncology pharmacist, told if I become positive they will infuse Bebtelovimab. Just wondering, if I do become positive should I go with the Bebtelovimab, or push for Paxlovid? On Zanubrutinib, zero antibodies from vaccines. Evusheld March 1st. Would need decreased dose of Paxlovid due to marginal kidney function. Hoping to stay negative, but would appreciate anyone’s experience with Bebtelovimab or Paxlovid.

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Davidcara profile image
Davidcara
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gardening-girl profile image
gardening-girl

Davidcara, I don't have any experience with either bebtelovimab or Paxlovid, but I did just read this recommendation from NIH Covid-19 Treatment Guidelines.

The Panel recommends ritonavir-boosted nirmatrelvir (Paxlovid) and remdesivir as preferred therapy options because Phase 3 randomized placebo-controlled trials have reported high clinical efficacies for these agents in patients with COVID-19. The Panel favors the use of ritonavir-boosted nirmatrelvir in most high-risk, nonhospitalized patients with mild to moderate COVID-19. If ritonavir-boosted nirmatrelvir is not available or cannot be used because of drug interactions, the Panel recommends using remdesivir as the second option. (my underlining)

The Panel recommends bebtelovimab and molnupiravir as alternative therapy options. These drugs should ONLY be used when neither of the preferred treatment options are available, feasible to use, or clinically appropriate. The Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for bebtelovimab based on in vitro data that showed that bebtelovimab has activity against all circulating Omicron subvariants and clinical efficacy data from a small, Phase 2 clinical trial in individuals with mild to moderate COVID-19 who were at low risk of disease progression. However, there are no Phase 3 clinical trial data for bebtelovimab. Molnupiravir had lower clinical efficacy in Phase 3 clinical trials than the preferred treatment options.

The "ONLY" in the paragraph above was not my addition. It is in the original text.

Therapeutic Management of Nonhospitalized Adults With COVID-19

Last Updated: April 8, 2022

covid19treatmentguidelines....

gardening-girl

Davidcara profile image
Davidcara in reply togardening-girl

Thanks gardening -girl. I have seen this too. I have actually seen some literature saying bebtelovimab does work with BA 4 and 5. So not sure what to think.

I just tested positive a few hours ago. Very faint line after swabbing my throat and nose. The on call internal medicine MD was hesitant to order paxlovid. I think my med list scared him off. Asked him to page my oncologist twice but, no response. He ordered bebtelovimab for tomorrow.

I’ll need to talk to my oncologist tomorrow to get his thoughts. For some reason, for cancer patients I think they are now pushing bebtelovimab, will see tomorrow

gardening-girl profile image
gardening-girl in reply toDavidcara

Very sorry to hear that you have tested positive, but really not at all surprised. Let us know about your treatment decision and how you are feeling over the next few days. Fingers crossed for an easy time of it for both you and your wife.

Jacksboy profile image
Jacksboy

I tested positive on Monday morning. I’ve been on Zanubrutinib for about a year after two years on ibrutinib. My oncologist and infectious disease docs agreed that bebtelovimab was the way to go. Got infusion on Wednesday. Had terrible chills and fever after coming home, but feeling better today. My wife tested positive earlier this evening. She’s hoping to get Paxlovid.

Bikram21 profile image
Bikram21

I got Covid in May (1 mth after receiving Evusheld) and had the Bebtelovimab infusion immediately. I never had much more than a runny nose for a few days. It would definitely be my pick over Paxlovid .

WittyApricot profile image
WittyApricot

I was given the Bebtelovimab infusion and I did well with it. My doc said because I was on other meds and supplements that this would be safer than paxlovid because Of interactions.

Davidcara profile image
Davidcara

Well, after many phone calls, got the bebtelovimab this afternoon. Just waiting for post observation now. The MD who was supposed to order it yesterday, dropped the ball and was unavailable today. Bit of a mess, but managed to get it ordered. If someone did not know the health care system, would never had happened. Anyways got the antibodies 24 hours after my first positive rapid test, which was confirmed with another rapid test this AM. Will post my progress, hopefully.

Claybuster profile image
Claybuster

Had covid symptoms and tested positive April 20. Thanks to Ohio state I received bebtelovimab next day. 4 hours after infusion I was terribly sick for 24 hours. Then cough, congestion for 3 weeks. Did bebtelovimab help? I guess. Three months later I finally feel like I did before Covid. For whatever reason, my CLL specialist never considered Paxlovid.Good luck.

skipro profile image
skipro

This is multi factorial

There is a long list of medications that would contraindicated use of Paxlovid

Bebteluvimab is the treatment of choice for CLL patients and if I test positive, I hope the supply hasn’t been depleted

Snowshoe

CLL patient and physician

Davidcara profile image
Davidcara in reply toskipro

Well if it is the treatment of choice or second tier, does not make much difference because, it is what I have received. I have actually read some encouraging information on bebtelovimab. There is the Lancet article. Also, some pushing for worldwide distribution. Will see how I do over the next few days.

skipro profile image
skipro in reply toDavidcara

Good luck Can you send me the Lancet article?Thx

bennevisplace profile image
bennevisplace in reply toskipro

thelancet.com/journals/lani... with apologies for cutting in but I just posted about this

Davidcara profile image
Davidcara in reply tobennevisplace

Thanks. There is actually some other positive bebtelovimab information online. Some are wondering if President Biden was actually given bebtelovimab and they only announced the Paxlovid

tesoro5858 profile image
tesoro5858 in reply toskipro

skipro, I have read that you are concerned about COVID and precautions that you and your family should take. I know how difficult it is when you need a higher level of precautions than others who are immune competent. I just tested positive for COVID 4 days ago after attending a family wedding where I was the only person masked. 150 people. I wore N95. So far, one other person tested positive that I know of. I received bebtelovimab the next day, and 60 hours later, I feel like I have turned the corner. Since I am severely immune compromised, I assume I likely would have great difficulty recovering without the mAb treatment, despite 3 vaccines and 2 rounds of Evusheld, the last round being 30 days prior to the wedding. I was very very sick. The bad news looming is the new variants, BQ.1 and BQ.1.1, are quickly gaining significantly and completely evade both Evusheld and bebtelovimab. Maybe this new information will help you decide how to protect yourself. I know it does for me. I hate to think how I would be recovering without those two substances onboard. I never want to experience COVID again.

skipro profile image
skipro in reply totesoro5858

Wow, in an N-95 at all times you still got Covid??

skipro profile image
skipro in reply toskipro

Also, how did you find bebteluvamab? I thought we had run out and wasn't going to be replaced?

tesoro5858 profile image
tesoro5858 in reply toskipro

I had a plan in place in case the worst happened, and since it did, I executed that plan so I knew where to go. I just read that the government purchased more bebtelovimab that is projected to last until 2023 at current usage rate. Of course, if it becomes useless against the new variants, that would be irrelevant.

tesoro5858 profile image
tesoro5858 in reply toskipro

Well, I did not mask outside but it was in northern Vermont and rather cold so not much outdoor activity. Also, I did eat but only with my immediate family table who were not infected and our table was segregated. None of them tested positive. It was not a perfect masked event for me but as close as I could get. I even drank my cocktail with my metal straw slipped under my mask.

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