Update on Early Combination Therapy with Lastest Monoclonal Antibodies and Antivirals as HIV, HCV, Influenza in Extremely Vulnerable Persons with Sars-Cov-2: A Literature Review and Clinical Experience

Journal of Clinical Medical Research, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 28

Published: Jan. 31, 2025

The emergence of new variants concern in immunocompromised persons with SARS-CoV-2, particularly those mutations the spike protein, has complicated treatment strategies. Some Therapies focused only on viral clearance effects and not major clinical outcomes. As virus continues to evolve, development broad-spectrum therapies, along personalized approaches treatment, will be crucial managing COVID-19 . After first year period which several treatments were employed early intervention strategies, including use antiretrovirals monoclonal antibodies, have emerged as promising mitigate severity fragile individuals prevent disease progression, hospitalization death even recent time less aggressive SARS-CoV-2 variants. Guidelines, high-quality data for combination exploiting antivirals neutralizing antibodies do exist outpatient setting, especially severe individuals. Nevertheless, studies attempted investigate efect this approach although these are often observational without control groups, generally no adverse reactions from therapy been reported. potential efficacy therapy, based an antiviral plus a antibody, severely patients is matter literature debate scientific word. To date, information concerning using combined therapies limited. In Literature Review we explain Last variant updates vulnerable Sars-Cov-2.

Language: Английский

In Vitro Combinatorial Activity of Direct Acting Antivirals and Monoclonal Antibodies against the Ancestral B.1 and BQ.1.1 SARS-CoV-2 Viral Variants

Published: Jan. 3, 2024

Combination antiviral therapy may be helpful in the treatment of SARS-CoV-2 infection, however no clinical trial data are available and combined use direct acting antivirals (DAA) monoclonal antibodies (mAb) has been reported only anecdotally. To assess cooperative effects dual drug combinations vitro, we used a VERO E6 cell based vitro system with ancestral B.1 or highly divergent BQ.1.1 virus to test pairwise licensed DAA, including nirmatrelvir (NRM), remdesivir (RDV) active metabolite molnupiravir (EIDD-1931) as well combination RDV four mAbs (sotrovimab, bebtelovimab, cilgavimab, tixagevimab; tested susceptible virus). According SynergyFinder 3.0 summary weighted scores, all had an additive effect. Within DAA/DAA combinations, paired scores variants were comparable. In post-hoc analysis weighting synergy by concentrations, several cases synergistic detected at specific both for RDV/mAb combinations. This was supported confirmation experiments showing more than linear shift effective concentration (IC50) increasing concentrations companion drug, although effect prominent but minimal null These results support which should further investigated animal models before introduction into clinic.

Language: Английский