Tixagevimab and Cilgavimab (Evusheld) Boosts Antibody Levels to SARS-Cov-2 in Patients with Multiple Sclerosis on B-Cell Depleters

INTRODUCTION: B-cell-depleting therapies may affect the development of a protective immune response following vaccination against SARS-CoV-2. It is important to have a different strategy for creating immunity. Evusheld (tixagevimab co-packaged with cilgavimab) is currently approved by the FDA under an emergency use authorization (EUA) for use in patients who are not able to mount an immune response to the COVID-19 vaccines. No study has been undertaken to evaluate its efficacy in people with MS. The objective of this study was to evaluate whether Evusheld (tixagevimab co-packaged with cilgavimab) affects the antibody response to SARS-CoV-2 following an existing attenuated response to the vaccines against SARS-CoV-2. MATERIAL(S) AND METHOD(S): This was a single-center cohort study performed at Methodist Hospitals in Merrillville, IN, USA. It included patients with multiple sclerosis treated with ocrelizumab and ofatumumab. Patients had already received the mRNA vaccinations against SARS-CoV-2 and had demonstrated an attenuated response on antibody testing. All participants received 150mg of Evusheld (tixagevimab co-packaged with cilgavimab). Antibody levels were measured at least two weeks following Evusheld injections. RESULT(S): All patients (100%) developed the highest level of antibodies possible at least two weeks following Evusheld injections. CONCLUSION(S): In this study, patients with MS who had an attenuated antibody response to the COVID-19 vaccines due to exposure to b-cell depleters now had the highest antibody response possible after receiving Evusheld. This is important as it provides a different strategy for protection against COVID-19.