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Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience

Effective treatments and vaccines against COVID-19 used in clinical practice have made a positive impact on controlling the spread of the pandemic, where they are available. Nevertheless, even if fully vaccinated, immunocompromised patients still remain at high risk of adverse outcomes. This has dri...

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Autores principales: Akinosoglou, Karolina, Rigopoulos, Emmanouil-Angelos, Kaiafa, Georgia, Daios, Stylianos, Karlafti, Eleni, Ztriva, Eleftheria, Polychronopoulos, Georgios, Gogos, Charalambos, Savopoulos, Christos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866621/
https://www.ncbi.nlm.nih.gov/pubmed/36680160
http://dx.doi.org/10.3390/v15010118
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author Akinosoglou, Karolina
Rigopoulos, Emmanouil-Angelos
Kaiafa, Georgia
Daios, Stylianos
Karlafti, Eleni
Ztriva, Eleftheria
Polychronopoulos, Georgios
Gogos, Charalambos
Savopoulos, Christos
author_facet Akinosoglou, Karolina
Rigopoulos, Emmanouil-Angelos
Kaiafa, Georgia
Daios, Stylianos
Karlafti, Eleni
Ztriva, Eleftheria
Polychronopoulos, Georgios
Gogos, Charalambos
Savopoulos, Christos
author_sort Akinosoglou, Karolina
collection PubMed
description Effective treatments and vaccines against COVID-19 used in clinical practice have made a positive impact on controlling the spread of the pandemic, where they are available. Nevertheless, even if fully vaccinated, immunocompromised patients still remain at high risk of adverse outcomes. This has driven the largely expanding field of monoclonal antibodies, with variable results. Tixagevimab/Cilgavimab (AZD7442), a long-acting antibody combination that inhibits the attachment of the SARS-CoV-2 spike protein to the surface of cells, has proved promising in reducing the incidence of symptomatic COVID-19 or death in high-risk individuals without major adverse events when given as prophylaxis, as well as early treatment. Real-world data confirm the antibody combination’s prophylaxis efficacy in lowering the incidence, hospitalization, and mortality associated with COVID-19 in solid organ transplant recipients, patients with immune-mediated inflammatory diseases and hematological malignancies, and patients in B-cell-depleting therapies. Data suggest a difference in neutralization efficiency between the SARS-CoV-2 subtypes in favor of the BA.2 over the BA.1. In treating COVID-19, AZD7442 showed a significant reduction in severe COVID-19 cases and mortality when given early in the course of disease, and within 5 days of symptom onset, without being associated with severe adverse events, even when it is used in addition to standard care. The possibility of the development of spike-protein mutations that resist monoclonal antibodies has been reported; therefore, increased vigilance is required in view of the evolving variants. AZD7442 may be a powerful ally in preventing COVID-19 and the mortality associated with it in high-risk individuals. Further research is required to include more high-risk groups and assess the concerns limiting its use, along the SARS-CoV-2 evolutionary trajectory.
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spelling pubmed-98666212023-01-22 Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience Akinosoglou, Karolina Rigopoulos, Emmanouil-Angelos Kaiafa, Georgia Daios, Stylianos Karlafti, Eleni Ztriva, Eleftheria Polychronopoulos, Georgios Gogos, Charalambos Savopoulos, Christos Viruses Review Effective treatments and vaccines against COVID-19 used in clinical practice have made a positive impact on controlling the spread of the pandemic, where they are available. Nevertheless, even if fully vaccinated, immunocompromised patients still remain at high risk of adverse outcomes. This has driven the largely expanding field of monoclonal antibodies, with variable results. Tixagevimab/Cilgavimab (AZD7442), a long-acting antibody combination that inhibits the attachment of the SARS-CoV-2 spike protein to the surface of cells, has proved promising in reducing the incidence of symptomatic COVID-19 or death in high-risk individuals without major adverse events when given as prophylaxis, as well as early treatment. Real-world data confirm the antibody combination’s prophylaxis efficacy in lowering the incidence, hospitalization, and mortality associated with COVID-19 in solid organ transplant recipients, patients with immune-mediated inflammatory diseases and hematological malignancies, and patients in B-cell-depleting therapies. Data suggest a difference in neutralization efficiency between the SARS-CoV-2 subtypes in favor of the BA.2 over the BA.1. In treating COVID-19, AZD7442 showed a significant reduction in severe COVID-19 cases and mortality when given early in the course of disease, and within 5 days of symptom onset, without being associated with severe adverse events, even when it is used in addition to standard care. The possibility of the development of spike-protein mutations that resist monoclonal antibodies has been reported; therefore, increased vigilance is required in view of the evolving variants. AZD7442 may be a powerful ally in preventing COVID-19 and the mortality associated with it in high-risk individuals. Further research is required to include more high-risk groups and assess the concerns limiting its use, along the SARS-CoV-2 evolutionary trajectory. MDPI 2022-12-30 /pmc/articles/PMC9866621/ /pubmed/36680160 http://dx.doi.org/10.3390/v15010118 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Akinosoglou, Karolina
Rigopoulos, Emmanouil-Angelos
Kaiafa, Georgia
Daios, Stylianos
Karlafti, Eleni
Ztriva, Eleftheria
Polychronopoulos, Georgios
Gogos, Charalambos
Savopoulos, Christos
Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience
title Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience
title_full Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience
title_fullStr Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience
title_full_unstemmed Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience
title_short Tixagevimab/Cilgavimab in SARS-CoV-2 Prophylaxis and Therapy: A Comprehensive Review of Clinical Experience
title_sort tixagevimab/cilgavimab in sars-cov-2 prophylaxis and therapy: a comprehensive review of clinical experience
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866621/
https://www.ncbi.nlm.nih.gov/pubmed/36680160
http://dx.doi.org/10.3390/v15010118
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