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COVID-19 therapies - alerts and advice

Latest updates
Wednesday 6 July 2022: 'Palivizumab'
section updated with latest Public Health Link alert.
Wednesday 1 June 2022: 'Neutralising monoclonal antibodies or antivirals' section updated with latest Interim Clinical Commissioning Policies, Public Health Links and Clinical Guides (hospital-onset and non-hospitalised patients).

Current therapeutic alerts and advice

Anticoagulation (heparin)

*COVID-19 Therapeutic Alert* Therapeutic Anticoagulation (Heparin) in the Management of Severe COVID-19 (SARS-CoV-2 Positive) Patients
Department of Health and Social Care and NHS (Issue date: 23 December 2020).
 

Antimicrobials (azithromycin and doxycycline)

*COVID-19 Therapeutic Alert* Antimicrobials (azithromycin and doxycycline) not beneficial in the management of COVID-19 (SARS-CoV-2) positive patients
Department of Health and Social Care and NHS (Issue date: 28 January 2021)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Covid-19 Therapeutic Alert - Antimicrobials (azithromycin and doxycycline) not beneficial in the management of Covid-19 (Sars-Cov-2) positive patients
Chief Medical Officer for Wales, Dr Frank Atherton (Published: 29 January 2021)
 

Baricitinib

*Public Health Link - Notification from the Chief Medical Officer for Wales* Baricitinib for Patients Hospitalised Due to COVID-19 (Adults and Children Aged 2 Years and Over)
Chief Medical Officer for Wales, Dr Frank Atherton (Published: 5 May 2022)

*Interim Clinical Commissioning Policy* Baricitinib for patients hospitalised due to COVID-19 (adults and children aged 2 years and over)
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 5 May 2022)

*Clinical Guide* Clinical pathway: Therapies for patients hospitalised due to COVID-19
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Published: 5 May 2022)

Supply of baricitinib for patients recruited to the recovery trial
Letter from Andrew Evans (Chief Pharmaceutical Officer for Wales) and Anne Hinchliffe (Specialist Pharmacist for Wales - Contingency Planning) (Issue date: 28 January 2021)
 

Colchicine

*COVID-19 Therapeutic Alert* Colchicine in the Management of COVID-19 (SARS-CoV-2) Positive Patients - Trial Use Only
Department of Health and Social Care and NHS (Issue date: 12 February 2021)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Colchicine in the Management of Covid-19 (Sars-Cov 2) Positive Patients - Trial Use Only
Chief Medical Officer for Wales, Dr Frank Atherton (Published: 12 February 2021)
 

Convalescent plasma

*COVID-19 Therapeutic Alert* Convalescent Plasma in the Management of Hospitalised Patients with COVID-19
Department of Health and Social Care, the Medicines and Healthcare products Regulatory Agency, and NHS (Issue date: 17 March 2021)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Convalescent Plasma in The Management Of Hospitalised Patients with Covid-19
Chief Medical Officer for Wales, Dr Frank Atherton (Published: 17 March 2021)
 

Corticosteroids

*Pharmaceutical Public Link - Notification from the Chief Pharmaceutical Officer for Wales* COVID-19 Therapeutic Alert: Withdrawal of the recommendation for consideration of inhaled budesonide as a treatment option for COVID-19
Chief Pharmaceutical Officer for Wales, Andrew Evans (Published: 14 December 2021)

*COVID-19 Therapeutic Alert* Withdrawal of the recommendation for consideration of inhaled budesonide as a treatment option for COVID-19
Department of Health and Social Care and NHS (Issue date: 14 December 2021)

*COVID-19 Therapeutic Alert* Corticosteroids in the treatment of suspected or confirmed COVID-19
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Issue date: 3 September 2020)
 

Interleukin-6 inhibitors (tocilizumab and sarilumab)

*Clinical Guide* Clinical pathway: Therapies for patients hospitalised due to COVID-19
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Published: 5 May 2022)
 

*Pharmaceutical Public Link - Notification from the Chief Pharmaceutical Officer for Wales* COVID-19 Therapeutic Alert: Interleukin-6 Inhibitors (tocilizumab or sarilumab) for adult patients hospitalised due to COVID-19
Chief Pharmaceutical Officer for Wales, Andrew Evans (Published: 1 February 2022)

*COVID-19 Therapeutic Alert* Interleukin-6 inhibitors (tocilizumab or sarilumab) for hospitalised patients with COVID-19 (adults)
Department of Health and Social Care and NHS (Published: 31 January 2022)

COVID-19 rapid guideline: managing COVID-19
NICE
 

Neutralising monoclonal antibodies or antivirals

Hospital-onset patients - interim clinical commissioning policies:

*Interim Clinical Commissioning Policy* Antivirals or neutralising monoclonal antibodies in the treatment of hospital-onset COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 30 May 2022)

*Interim Clinical Commissioning Policy - Clinical Guide* Therapies for patients with symptomatic hospital-onset COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 30 May 2022)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Antivirals or neutralising monoclonal antibodies in the treatment of hospital-onset COVID-19
Chief Medical Officer for Wales, Sir Frank Atherton (Published: 1 June 2022)

 

Non-hospitalised patients - interim clinical commissioning policies:

*Public Health Link - Notification from the Chief Medical Officer for Wales* Antivirals or neutralising antibodies for non-hospitalised patients with COVID-19
Chief Medical Officer for Wales, Sir Frank Atherton (Published: 1 June 2022)

*Interim Clinical Commissioning Policy* Antivirals or neutralising monoclonal antibodies for non-hospitalised patients with COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 30 May 2022)

*Interim Clinical Commissioning Policy - Clinical Guide* Therapies for symptomatic non-hospitalised patients with COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 30 May 2022)

 

Other resources:

National COVID-19 treatment Patient Group Directions (PGDs): (Ronapreve®) casirivimab and imdevimab 120mg/mL solution for the treatment of mild to moderate COVID‑19 infection in adults and children at high risk for severe disease
Welsh Medicines Information Centre

National COVID-19 treatment Patient Group Directions (PGDs): (Lagevrio®) molnupiravir 200mg capsules for the treatment of mild to moderate coronavirus disease in high risk individuals for severe disease
Welsh Medicines Information Centre

Casirivimab and imdevimab (Specialist Pharmacist Service)
SPS has compiled guidance and supporting documents for Chief Pharmacists, to achieve institutional readiness and deployment of casirivimab/imdevimab (Ronapreve)

Regulatory approval of Ronapreve
Medicines and Healthcare products Regulatory Agency (19 November 2021)

COVID-19 rapid guideline: managing COVID-19
NICE
 

Palivizumab

*Public Health Link - Notification from the Chief Medical Officer for Wales* COVID-19 Therapeutic Alert: Commencement of a Palivizumab Passive Immunisation Programme Against Respiratory Syncytial Virus (RSV) in At-Risk Infants in Wales
Sir Frank Atherton, Chief Medical Officer for Wales (Published: 6 July 2022)

Remdesivir

COVID-19 rapid guideline: managing COVID-19
NICE (Updated 19 May 2022)

*Pharmaceutical Public Link - Notification from the Chief Pharmaceutical Officer for Wales* COVID-19 Therapeutic Alert: Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older)
Chief Pharmaceutical Officer for Wales, Andrew Evans (Published: 25 February 2022)

*COVID-19 Therapeutic Alert* Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older)
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency and NHS (Issue date: 24 February 2022)

*Interim Clinical Commissioning Policy* Remdesivir for patients hospitalised due to COVID-19 (adults and children 12 years and older) Version 4
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 24 February 2022)

*Clinical Guide* Clinical pathway: Therapies for patients hospitalised due to COVID-19
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Published: 5 May 2022)
 

 

Previous versions of alerts and advice

Casirivimab/imdevimab (Ronapreve)

*Public Health Link - Notification from the Chief Medical Officer for Wales* COVID-19 Therapeutic Alert - Casirivimab and imdevimab for patients hospitalised due to COVID-19
Chief Medical Officer for Wales, Dr Frank Atherton and Andrew Evans, Chief Pharmaceutical Officer for Wales (Updated: 4 November 2021)

*Public Health Link - Notification from the Chief Medical Officer for Wales* COVID-19 Therapeutic Alert - Casirivimab and imdevimab for patients hospitalised due to COVID-19
Chief Medical Officer for Wales, Dr Frank Atherton and Andrew Evans, Chief Pharmaceutical Officer for Wales (Updated: 20 September 2021)
 

Corticosteroids

*Pharmaceutical Public Link - Notification from the Chief Pharmaceutical Officer for Wales* COVID-19 Therapeutic Alert: Inhaled budesonide for adults (50 years and over) with COVID-19
Chief Pharmaceutical Officer for Wales, Andrew Evans (Published: 13 April 2021)

*COVID-19 Therapeutic Alert* Inhaled budesonide for adults (50 years and over) with COVID-19
NHS (Issue date: 12 April 2021)

*Interim Position Statement* Inhaled budesonide for adults (50 years and over) with COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 12 April 2021)

*COVID-19 Therapeutic Alert* Dexamethasone in the treatment of COVID-19: Implementation and management of supply for treatment in hospitals
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Issue date: 16 June 2020)
 

Interleukin-6 inhibitors (tocilizumab and sarilumab)

*Pharmaceutical Public Link - Notification from the Chief Pharmaceutical Officer for Wales* COVID-19 Therapeutic Alert: Interleukin-6 Inhibitors (tocilizumab or sarilumab) for adult patients hospitalised due to COVID-19
Chief Pharmaceutical Officer for Wales, Andrew Evans (Published: 14 September 2021)

*Interim Clinical Commissioning Policy* IL-6 inhibitors (tocilizumab or sarilumab) for hospitalised patients with COVID-19 (adults)
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 12 September 2021)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Interleukin-6 Inhibtors (Tocilizumab and Sarilumab) for Critically Ill Patients with COVID-19 Pneumonia (adults)
Chief Medical Officer for Wales, Dr Frank Atherton (Published: 1 February 2021)

*COVID-19 Therapeutic Alert* Interleukin-6 inhibitors (tocilizumab or sarilumab) for critically ill patients with COVID-19 pneumonia (adults)
Department of Health and Social Care and NHS (Issue date: 1 February 2021)

*Interim Clinical Commissioning Policy* Sarilumab for critically ill patients with COVID-19 pneumonia (adults)
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 1 February 2021)

*Interim Clinical Commissioning Policy* Tocilizumab for critically ill patients with COVID-19 pneumonia (adults)
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 1 February 2021)

*COVID-19 Therapeutic Alert* Interleukin-6 inhibitors (tocilizumab or sarilumab) for patients admitted to ICU with COVID-19 pneumonia (adults)
Department of Heatlh and Social Care and NHS (Issue date: 8 January 2021)

*Interim Position Statement* Interleukin-6 inhibitors (tocilizumab or sarilumab) for patients admitted to ICU with COVID-19 pneumonia (adults)
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 8 January 2021)

COVID-19 rapid evidence summary: Tocilizumab for COVID-19
NICE (Published: 15 January 2021)

COVID-19 rapid evidence summary: Sarilumab for COVID-19
NICE (Published: 20 January 2021)
 

Neutralising monoclonal antibodies or antivirals

Hospitalised patients - interim clinical commissioning policies:

*Interim Clinical Commissioning Policy* Antivirals or neutralising monoclonal antibodies in the treatment of COVID-19 in hospitalised patients
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 27 January 2022)

*Interim Clinical Commissioning Policy - Clinical Guide* Therapies for patients with symptomatic hospital-onset COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 27 January 2022)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Antivirals and neutralising monoclonal antibodies (nMABs) in the treatment of hospitalised patients with COVID-19
Chief Medical Officer for Wales, Sir Frank Atherton (Published: 28 January 2022)

*Interim Clinical Commissioning Policy* Neutralising monoclonal antibodies and intravenous antivirals in the treatment of COVID-19 in hospitalised patients
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 4 January 2022)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Neutralising monoclonal antibody and intravenous antiviral treatments for patients in hospital with COVID-19 infection
Chief Medical Officer for Wales, Dr Frank Atherton (Published: 4 January 2022)

Non-hospitalised patients - interim clinical commissioning policies:

*Interim Clinical Commissioning Policy* Antivirals or neutralising monoclonal antibodies for non-hospitalised patients with COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 27 January 2022)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Antivirals or neutralising monoclonal antibodies (nMABs) for non-hospitalised patients with COVID-19
Chief Medical Officer for Wales, Sir Frank Atherton (Published: 28 January 2022)

*Interim Clinical Commissioning Policy* Neutralising monoclonal antibodies or antivirals for non-hospitalised patients with COVID-19
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 24 December 2021)

*Public Health Link - Notification from the Chief Medical Officer for Wales* Neutralising monoclonal antibodies (nMABs) or anticirals for non-hospitalised patients with COVID-19
Chief Medical Officer for Wales, Dr Frank Atherton (Published: 4 January 2022)
 

Palivizumab

*Public Health Link - Notification from the Chief Medical Officer for Wales* COVID-19 Therapeutic Alert: Palivizumab passive immunisation against respiratory syncytial virus (RSV) in at risk pre-term infants
Chief Medical Officer for Wales, Sir Frank Atherton and Andrew Evans, Chief Pharmaceutical Officer for Wales (Published: 31 January 2022)

*COVID-19 Rapid Policy Statement* Palivizumab passive immunisation against Respiratory Syncytial Virus (RSV) in at-risk pre-term infants
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Issue date: January 2021)

*COVID-19 Rapid Policy Statement* Palivizumab passive immunisation against respiratory syncytial virus (RSV) in at-risk pre-term infants
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Issue date: October 2020)

*Public Health Link - Notification from the Chief Medical Officer for Wales* COVID-19 Therapeutic Alert: Palivizumab passive immunisation against respiratory syncytial virus (RSV) in at risk pre-term infants.
Chief Medical Officer for Wales, Dr Frank Atherton and Andrew Evans, Chief Pharmaceutical Officer for Wales (Published: 30 June 2021)

*COVID-19 Rapid Policy Statement* Palivizumab passive immunisation against respiratory syncytial virus (RSV) in at-risk pre-term infants
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Issue date: June 2021)
 

Remdesivir

*Pharmaceutical Public Link - Notification from the Chief Pharmaceutical Officer for Wales* COVID-19 Therapeutic Alert: Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older)
Chief Pharmaceutical Officer for Wales, Andrew Evans (Published: 15 June 2021)

*COVID-19 Therapeutic Alert* Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older)
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency and NHS (Issue date: 14 June 2021)

*Interim Clinical Commissioning Policy* Remdesivir for patients hospitalised with COVID-19 (adults and children 12 years and older) Version 3
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 14 June 2021)

Publication Of A Revised Clinical Commissioning Policy: Remdesivir For Patients Hospitalised With Covid-19 (Adults And Children Aged 12 Years And Older)
Chief Pharmaceutical Officer for Wales, Andrew Evans (Published: 9 November 2020)

Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older) – Supply Disruption
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Issue date: 29 September 2020)

*COVID-19 Therapeutic Alert* Publication of a revised interim clinical commissioning policy: Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older)
Department of Health and Social Care and NHS (Issue date: 6 November 2020)

*Interim Clinical Commissioning Policy* Remdesivir for patients hospitalised with COVID-19 (adults and children 12 years and older) Version 2
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Northern Ireland), and NHS (Published: 6 November 2020)

COVID-19 rapid evidence summary: Remdesivir for treating hospitalised patients with suspected or confirmed COVID-1
NICE (Published: 5 June 2020

Publication of an interim clinical commissioning policy: Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older)
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Issue date: 3 September 2020)

Interim Clinical Commissioning Policy: Remdesivir for patients hospitalised with COVID-19 (adults and children 12 years and older)
Department of Health and Social Care, Welsh Government, The Scottish Government, Department of Health (Norther Ireland), and NHS (Issue date: 6 July 2020)

Publication of an interim clinical commissioning policy: Remdesivir for patients hospitalised with COVID-19 (adults and children aged 12 years and older) - A letter from the Chief Pharmaceutical Officer for Wales
Chief Pharmaceutical Officer for Wales (Published: 6 July 2020)

Early Access to Medicines Scheme for remdesivir in the treatment of COVID-19. Implementation of the scheme and management of supply
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Issue date: 9 June 2020)

EAMS: Remdesivir treatment protocols
Medicines and Healthcare Regulatory Agency (Published: 26 May 2020)

Early Access to Medicines Scheme for remdesivir in the treatment of COVID-19. Implementation of the scheme and management of supply
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Issue date: 3 June 2020)

Early Access to Medicines Scheme for remdesivir in the treatment of COVID-19. Implementation of the scheme and management of supply
Department of Health and Social Care, Medicines and Healthcare Regulatory Agency, and NHS (Issue date: 26 May 2020)

COVID-19 rapid evidence summary: Remdesivir for treating hospitalised patients with suspected or confirmed COVID-19
NICE (Published: 5 June 2020)

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