You’ll hear about the new COVID-19 treatment vilobelimab (Gohibic)...due to its emergency use authorization (EUA).
This med is a “complement inhibitor”...and it’s only authorized for treating COVID-19 in certain adults on mechanical ventilation or extracorporeal membrane oxygenation (ECMO).
Vilobelimab seems to reduce the risk of death when added to a steroid (dexamethasone, etc). But there are important limitations to the evidence supporting its use.
Expect to continue dispensing tocilizumab (Actemra) or baricitinib (Olumiant) as the go-to add-on to steroids for COVID-19.
These meds also seem to reduce mortality in critically ill patients...plus they can be used in a broader range of patients, may be more practical, and are likely to cost less.
But familiarize yourself with vilobelimab in case it’s ordered.
Look for vilobelimab to come in 200 mg/20 mL single-dose vials. It’ll be given as an 800 mg IV infusion for up to 6 doses...on days 1, 2, 4, 8, 15, and 22.
Anticipate that vilobelimab will be started when patients are in the ICU...the first dose must be given within 48 hours of intubation or initiation of ECMO.
Don’t be surprised if some subsequent doses are dispensed when patients are in floor beds. The course will continue while the patient is in-house, even if they transfer out of the ICU.
Review our resource, Treatments of Interest for COVID-19, for a refresher on various meds.
- https://www.fda.gov/drugs/emergency-preparedness-drugs/emergency-use-authorizations-drugs-and-non-vaccine-biological-products (5-31-23)
- https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/ (5-31-23)
- Lancet Respir Med. 2022 Dec;10(12):1137-1146