AI Article Synopsis

  • - Tixagevimab-cilgavimab is approved for immunocompromised patients as a preventive treatment, even amid the spread of the Omicron variant (specifically BA.5) and serves as support or an alternative to vaccination.
  • - The study measured neutralizing antibody levels in fully vaccinated immunocompromised patients following treatment, finding that only 12.5% achieved adequate antibody levels against BA.5, while most had lower responses compared to another variant.
  • - The results indicate that tixagevimab-cilgavimab should not replace vaccination but may be beneficial as a supplementary treatment if the dosage is increased.

Article Abstract

Background: Tixagevimab-cilgavimab has been approved as primary pre-exposure prophylaxis in immunocompromised patients as support or replacement for vaccination, even though the Omicron variant of concern (VOC) was spreading at the time.

Objectives: The aim of our study was to evaluate the post-injection neutralising activity (NT-Abs titre) against the Omicron BA.5 variant in fully vaccinated immunocompromised patients.

Study Design: NT-Abs titres against BA.5 and 20A.EU1 as well as anti-spike and anti-receptor-binding domain IgG were evaluated 0, 14, and 30 d after tixagevimab-cilgavimab administration. The primary end point was NT-Abs titres ≥ 80 against BA.5 in ≥ 25% of patients, and the secondary end point was NT-Abs titres ≥ 1280 against 20A.EU1 in >50% of patients on day 14.

Results: At baseline, 35.2%, 37.02%, and 32.5% of booster vaccinated patients exhibited undetectable levels of anti-S and anti-RBD IgG antibodies such as NT-Abs titres against A20.EU1. Moreover, 35 patients (61.5%) had undetectable NT-Abs titres against BA.5. On day 14, IgG anti-S and anti-RBD levels were 3880 BAU/mL and 776.6 AU/mL, respectively. Only 12.5% of patients met a NT-Abs titres ≥ 80 against BA.5, whereas the median NT-Abs titre against 20A.EU1 was 1280. NT-Abs titres against BA.5 were 64-fold lower than those against A20.EU1. Four patients (7.5%) had a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the 3 months after treatment, all with a time gap between the booster vaccination and injection.

Conclusions: To date, tixagevimab-cilgavimab cannot be considered a substitute for vaccination but may be a useful supporting therapy if the recommended dose for pre-exposure prophylaxis is doubled.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcv.2023.105584DOI Listing

Publication Analysis

Top Keywords

nt-abs titres
16
pre-exposure prophylaxis
12
titres ba5
12
nt-abs
9
omicron ba5
8
booster vaccinated
8
vaccinated immunocompromised
8
patients
8
immunocompromised patients
8
nt-abs titre
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!