How will you use REGEN-COV (casirivimab/imdevimab-monoclonal antibody treatment recently approved under EUA as post-exposure prophylaxis for Covid) in rheumatic patients on immunosuppressive therapy?

Like most other treatments, I've tried to triage use of REGEN-COV post-exposure prophylaxis (PEP) based on the other risk factors that a patient has:

The NEJM study published by O'Brien et al. PMID 34347950 did show marked benefit in REGEN-COV post-exposure prophylaxis vs. placebo in the (a) decreasing incidence of symptomatic infection, (b) decreasing the duration of symptoms for those who developed symptomatic infection, and (c) decreasing the duration of high-viral load for those with either symptomatic or asymptomatic infection.

Though the study has limited applicability to our populations since only 22 of the subjects (i.e., less than 1.5% of the study population) had either immunosuppressive disease or were on immunosuppressive medicati...

I have a rheumatoid arthritis patient with ILD whose husband had COVID. She could not get post-exposure prophylaxis in Texas without a positive test. I appealed to several centers. We did get her husband treated with monoclonal antibodies to decrease the viral load. She self-tested daily at home for 10 days. She did not get COVID.