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The number of medications available to treat COVID-19 continues to get smaller as the coronavirus changes to outsmart treatments. The FDA said last week that bebtelovimab, a monoclonal antibody drug given through a vein, is no longer authorized because it is not effective against the leading strains of COVID-19.

Bebtelovimab, made by Eli Lilly, was the last remaining monoclonal antibody treatment of six that had been authorized for emergency use during the pandemic. It was an important option for some people with COVID-19 because it didn’t react negatively with immunosuppressive drugs taken by people with cancer or those who have received an organ or other transplant, NBC News reported.

Monoclonal antibodies are made in a laboratory. They find poisons in the body, stick to them, and destroy them, according to the Cleveland Clinic, which added that their generic names often include the letters “mab” at the end.

“The big problem is that monoclonal antibodies bind to a very small piece of the virus. As the virus changes, we are now in a position in which we lost them all because they don’t bind to the virus anymore,” Johns Hopkins School of Medicine professor Arturo Casadevall, MD, PhD, told NBC News.

Bebtelovimab is not effective against the current primary coronavirus strains of BQ.1 and BQ.1.1. Combined, the two strains account for about 63% of all cases nationwide, according to CDC data for the week ending Dec. 3.

The FDA announcement stated that antiviral treatments, including remdesivir, Paxlovid, and Lagevrio, are all still options for patients at high risk for a severe case of COVID-19. Antivirals work “by stopping the coronavirus from replicating in the body,” says a summary from the U.S. Department of Health of Human Services, adding that “this lowers the viral load, reducing the chances of the illness progressing to more serious symptoms and hospitalization.”

COVID-19 is on the rise nationwide, with hospitalizations averaging more than 35,000 per day. This is a 26% increase over the past two weeks, according to  The New York Times‘ tracker.

“Cases, hospitalizations and test positivity are all rising at the national level, suggesting that the relative stability seen this fall could be coming to an end,” the Times summarized. “Daily case and death data are subject to fluctuations around Thanksgiving that do not affect other metrics. It is therefore particularly concerning to see hospitalizations and test positivity — the most reliable data at this time of year — rising sharply.”

Sources:

FDA: “FDA Announces Bebtelovimab is Not Currently Authorized in Any US Region.”

NBC News: “New coronavirus variants rendered the last remaining monoclonal antibody treatment useless.”

Cleveland Clinic: “Monoclonal Antibodies.”

CDC: “COVID-19 Data Tracker Variant Proportions Nowcast.”

DHHS: “Lagevrio (molnupiravir),” “Veklury (remdesivir),” “Paxlovid.”

The New York Times: “Coronavirus in the U.S.: Latest Map and Case Count Updated Dec. 4, 2022.”

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