Ronapreve (Casirivimab 120 mg mg/ml imdevimab 120mg/ml) injection

Ronapreve, also known as the  Casirivimab and Imdevimab Injection, is a combination monoclonal antibody therapy developed by Regeneron Pharmaceuticals and Roche. It is designed for the treatment and prevention of COVID-19, the disease caused by the SARS-CoV-2 virus. Monoclonal antibodies like casirivimab and imdevimab are laboratory-made molecules that mimic the immune system’s ability to fight off harmful pathogens such as viruses. Ronapreve was granted emergency use authorization in various countries during the COVID-19 pandemic to help reduce the severity of the disease and prevent infection in certain populations.

How It Works

Ronapreve functions by targeting the spike protein of the SARS-CoV-2 virus. Here is a detailed explanation of its mechanism of action: 1. **Monoclonal Antibodies**: – **Casirivimab** and **Imdevimab** are monoclonal antibodies that are specifically engineered to bind to the spike protein of SARS-CoV-2. This spike protein is essential for the virus to enter human cells, as it binds to the angiotensin-converting enzyme 2 (ACE2) receptors on the surface of host cells. 2. **Blocking Viral Entry**: – By binding to different sites on the spike protein, casirivimab and imdevimab prevent the virus from attaching to the ACE2 receptors. This dual binding blocks the virus’s entry into the cells, effectively neutralizing it and preventing the infection from spreading in the body. 3. **Preventing Viral Replication**: – Once the antibodies block the spike protein, the virus cannot replicate within the host cells. This helps to control and reduce the viral load in infected individuals, leading to a reduction in disease severity and progression. 4. **Synergistic Action**: – The combination of casirivimab and imdevimab is more effective than either antibody alone. By targeting distinct epitopes on the spike protein, these antibodies work synergistically to enhance the neutralization of the virus, providing robust protection against the infection. 5. **Reduction in Hospitalization and Mortality**: – Clinical trials have demonstrated that Ronapreve can significantly reduce the risk of hospitalization and death in high-risk patients with mild to moderate COVID-19. It is particularly beneficial for those who have not yet developed a robust immune response or who have underlying health conditions that put them at higher risk of severe disease.

Indications

Ronapreve is indicated for:

• Treatment of COVID-19:
  • **Mild to Moderate COVID-19**: Ronapreve is used in the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age and older weighing at least 40 kg) who are at high risk for progressing to severe COVID-19 and/or hospitalization.
• Prevention of COVID-19:
  • **Post-Exposure Prophylaxis**: Ronapreve can be used for post-exposure prophylaxis of COVID-19 in individuals who are at high risk of severe disease and have been exposed to the SARS-CoV-2 virus.
  • **Pre-Exposure Prophylaxis**: In certain cases, Ronapreve may be administered to individuals who are at high risk of exposure and are not expected to mount an adequate immune response to COVID-19 vaccination due to underlying medical conditions.

Side Effects

Ronapreve may cause a range of side effects, from mild to severe. Common and serious side effects include:

• Common Side Effects:
  • Fever
  • Chills
  • Headache
  • Fatigue
  • Diarrhea
  • Nausea
  • Vomiting
  • Injection site reactions (pain, redness, swelling)
  • Dizziness
• Serious Side Effects:
  • **Hypersensitivity Reactions**: Symptoms may include rash, itching, swelling, and difficulty breathing. Severe allergic reactions, including anaphylaxis, have been reported. Patients should seek immediate medical attention if they experience any signs of an allergic reaction.
  • **Infusion-Related Reactions**: Some patients may experience infusion-related reactions, which can range from mild to severe. Symptoms may include fever, difficulty breathing, rapid heartbeat, sweating, and hypotension.
  • **Thromboembolic Events**: Although rare, there is a potential risk for blood clots forming in veins or arteries, leading to conditions like deep vein thrombosis (DVT) or pulmonary embolism (PE).

Contraindications

Ronapreve is contraindicated in the following situations:

• Hypersensitivity: Patients with known hypersensitivity to casirivimab, imdevimab, or any components of the product should not use Ronapreve.
• Severe Allergic Reactions: Individuals who have experienced severe or life-threatening hypersensitivity reactions to monoclonal antibodies should avoid using Ronapreve unless an appropriate management protocol is in place.

Pricing Information

Below is a table detailing the price of Ronapreve in various countries:

Country	Price (per dose)	Reference
United States	$1,250 – $2,100	GoodRx
United Kingdom	£1,000 – £1,700	NHS
Australia	AUD $1,500 – $2,200	PBS
Canada	CAD $1,600 – $2,400	DrugBank
Germany	€1,200 – €1,800	Apotheken Umschau

Top 5 Global Brands

Several pharmaceutical companies produce monoclonal antibody therapies for COVID-19. Here are some of the top global brands:

• REGEN-COV (Casirivimab and Imdevimab) – Regeneron Pharmaceuticals
• Sotrovimab (VIR-7831) – GlaxoSmithKline and Vir Biotechnology
• Evusheld (Tixagevimab and Cilgavimab) – AstraZeneca
• Regkirona (Regdanvimab) – Celltrion
• Bamlanivimab and Etesevimab – Eli Lilly and Company