Circulating SARS-CoV-2 viral variants may be assoc w/ resistance to monoclonal antibodies.
Step 1: Check CDC genomic surveillance site(s) for variant prevalence.
Step 2: Check Monoclonal Antibody Activity to determine optimal monoclonal antibody tx.
Step 1: Check CDC Surveillance of SARS-CoV-2 Variants in U.S.
Step 2: See predicted monoclonal antibody activity against SARS-CoV-2 variants
Prioritization in situations of limited drug availability
- If logistical constraints or limited availability, NIH recommends prioritization of use of monoclonal antibodies
- REGEN-COV and bamlanivimab and etesevimab no longer directly available from Amerisource Bergen. Distribution determined by individual state/territorial health departments: DHHS website
- Availability of bamlanivimab & etesevimab may be restricted in areas that have an elevated prevalence of select variants of concern w/ markedly reduced in vitro susceptibility (eg, P.1 [Gamma], B.1.351 [Beta]). Refer to US Dept of Health and Human Services website for updates
- FDA list of states in which distribution/use of bamlanivimab & etesevimab authorized as of 9/15/21: FDA site
Fold Reduction in Susceptibility
Variant Classifications and Definitions
View epocrates drug info:
bamlanivimab EUA Healthcare Provider Fact Sheet
Bamlanivimab monotherapy EUA revoked April 16, 2021: FDA letter
, press release
bamlanivimab and etesevimab EUA Healthcare Provider Fact Sheet
FDA list of states
in which distribution/use of bamlanivimab + etesevimab authorized as of 8/27/21 (based on combined frequency of variant resistance ≤5%).
REGEN-COV EUA Healthcare Provider Fact Sheet
sotrovimab EUA Healthcare Provider Fact Sheet
5 NIH 2021.
COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Last update 4/8/21. Accessed 4/13/21
Based on authentic SARS-CoV-2 neutralization data.
This epocrates resource is developed by our in-house team of pharmacist and physician editors.
Epocrates Guideline Synopsis Last Update:
Sep 28, 2021