Kingman Regional Medical Center Documents Update Supervisors On Virus Treatments | Kingman Daily Miner


KINGMAN – Doctors at Kingman Regional Medical Center on Monday, December 6, provided the Mohave County Board of Supervisors with an overview of early treatment therapies for COVID-19, which included an explanation of why ivermectin did not is not prescribed by the hospital.

Dr Adam Dawson, the medical director of the KRMC emergency room; Dr Tyson Dietrich, pharmacist specializing in infectious diseases; and Clinical Research Administrator Anthony Santarelli, Ph.D, attended the board meeting on Monday. Santarelli opened the presentation with an overview of the data relating to outpatient therapies available to those who have contracted COVID-19.

He classified these therapies into three groups; those who have received emergency use authorization from the Food and Drug Administration, those who are currently investigational or investigational drugs; and the therapies that were invalidated.

Monoclonal ambulatory infusions such as bamlanivimab and etesevimab, casirivimab and imdevimab are in the first group.

“So that also includes the new drugs that are being evaluated by the FDA, and that’s your oral antiviral pills like molnupiravir,” Santarelli explained.

The second group – currently experimental or experimental therapies – includes fluvoxamine, a serotonin reuptake inhibitor, as well as ivermectin, an antiparasitic. Santarelli said therapies that have been invalidated include COVID-19 convalescent plasma and hydroxychloroquine.

“Healthcare providers across Mohave County are making decisions about what to offer based on the best available evidence, whether they support or deny the use of a certain drug,” Santarelli said.

Citing data from the New England Journal of Medicine and the American Journal of Emergency Medicine, Santarelli said patients who have used the monoclonal therapies bamlanivimab and etesevimab are seeing results.

“They received their approval from the FDA based on a few critical data points, first and foremost, that seven days after the infusion in sick patients, people who received this drug showed a reduction in their burden. viral, which means they had less virus circulating throughout their body, “Santarelli said.

He added that the study was quickly followed by a report that showed a faster reduction in symptom severity from six days to three days in patients who took the drug.

“All of this has resulted in a reduction in the number of patients requiring hospitalization or expiring from approximately 6% to just under 2% in patient populations,” Santarelli said. “KRMC independently replicated these data and we found a more modest effect, but patients who received these outpatient monoclonal therapies, particularly bamlanivimab, experienced reduced hospital performances due to worsening symptoms of 6.3% to 4.4%. “

He added that the number of people returning to the hospital because they were getting sicker had decreased by 10.9% thanks to the use of the drug. Regeneron monoclonal therapies then received FDA clearance due to a reduced viral load in patients seven days after the infusion.

“We then started giving this and we are still administering it, with a slightly improved result with monoclonal bamlanivimab, with a reduction in the number of patients requiring hospitalization after this infusion by up to 4.3%”, continued Santarelli. .

KRMC has chosen Regeneron monoclonal therapies as the primary outpatient management of COVID-19. Oral antiviral pills are not currently administered by KRMC, but hospital staff are monitoring the data. Fluvoxamine is still experimental and experimental for the treatment of COVID-19, but Santarelli said the data is promising.

“Patients receiving this drug may experience reduced damage to lung tissue from COVID-19,” he said. “In addition, administration of fluvoxamine has been associated with a reduction in patient care for worsening symptoms, as well as a potential reduction in mortality, afforded less than monoclonal therapies, with a reduction in 2% in the placebo groups to 1% in patients who received this SSRI (selective serotonin reuptake inhibitors).

Ivermectin also remains under study.

“Unfortunately, this appears to be less promising than fluvoxamine with no detectable difference in the time to symptom resolution in patients given this drug compared to a placebo,” Santarelli said. “Additionally, patients receiving ivermectin were more likely to return to hospital due to worsening symptoms, and administration of this drug was associated with a three-fold increase in serious side effects.”

He said that while some data support the use of ivermectin, the increase in serious side effects and associated necessary hospitalizations “requires a greater degree of evidence for its efficacy or usefulness than is currently available. , and is not offered by KRMC “.

Dawson explained that to be prescribed investigative drugs for COVID-19, one must be over 65 with a positive COVID test, less than 10 sick days, out of hospital and without supplemental oxygen.

“So if I go to KRMC and I’m dying and want ivermectin or my family wants to try ivermectin, you wouldn’t give it to them,” District Supervisor Hildy Angius asked. 2.

Dawson said he would not administer ivermectin to his family members.

“There are still arguments both ways for this. The initial evidence that excited us about this, in fact, has been largely refuted. Having said that, there is still a lot of enthusiasm about it, ”said Dawson.

“Truly, over time, nothing has shown an absolute benefit in really any patient population, let alone inpatients,” Dietrich added, saying the hospital encourages therapies that have the best evidence behind them.

Angius also asked if COVID-19 was listed as the cause of death, which Dietrich said is determined by the attending physician. Angius asked if she had COVID two years ago but now dies, would she be listed as a previously confirmed case.

“Absolutely not,” Dawson said. “I, like you, saw the news very early on because everything was COVID death, anything that could be called COVID was called COVID. We agree with you that this is just plain silly. The reality is that there is a little more than that.

District 4 Supervisor Jean Bishop inquired about the mental health impacts of COVID-19 on older patients on oxygen with little hope of recovery.

“Individuals in our community here suffer from very high rates of stress, suppression and suicidal ideation,” Santarelli said. “Although we have no evidence that they are increasing, this is a major concern. Going back and being able to reintegrate your peers and community members is really the best way to fight this. “

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