Efficacy and safety of antiviral plus anti-spike monoclonal antibody combination therapy vs. monotherapy for high-risk immunocompromised patients with mild-to-moderate SARS-CoV2 infection during the Omicron era: A prospective cohort study
International Journal of Antimicrobial Agents,
Год журнала:
2024,
Номер
63(3), С. 107095 - 107095
Опубликована: Янв. 21, 2024
Antivirals
and
monoclonal
antibodies
are
available
to
lower
progression
risk
in
immunocompromised
patients.
However,
combination
therapy
with
both
types
of
agents
has
not
been
studied.
Single-centre
prospective
cohort
study.
We
enrolled
all
patients
who
received
treatment
for
mild-to-moderate
COVID-19
from
January
1st,
2022,
October
30th,
2022.
Primary
endpoint
was
at
90
days,
defined
as
hospital
admission
or
death
due
and/or
seronegative
persistent
Three
hundred
four
(304)
were
included.
43
(14.1%)
sotrovimab
plus
a
direct-acting
antiviral
261
(85.9%)
monotherapy.
outcome
occurred
more
frequently
after
monotherapy
(4.6%
vs
0%,
p=0.154).
Among
anti-Spike
IgG
titter
below
750
BAU/mL,
frequent
(23.9%
p=0.001),
including
COVID-related
(15.2%
p=0.014)
(10.9%
p=0.044).
Combination
associated
(OR
0.08,
95%
CI
0.01-0.64).
Anti-S
than
BAU/mL
previous
antiCD20
higher
13.70,
2.77-67.68;
OR
3.05,
1.20-10.94,
respectively).
In
immunocompromised,
an
may
be
effective
SARS-CoV2.
Язык: Английский
Monoclonal antibodies as COVID-19 prophylaxis therapy in immunocompromised patient populations
International Journal of Infectious Diseases,
Год журнала:
2023,
Номер
134, С. 228 - 238
Опубликована: Июль 1, 2023
The
objective
of
this
review
was
to
examine
the
latest
literature
regarding
effectiveness
monoclonal
antibodies
as
COVID-19
prophylaxis
therapy
for
immunocompromised
patient
populations.Literature
published
real-world
and
randomized
control
trials
(RCTs)
from
2020
May
2023.COVID-19
is
highly
transmissible
with
potentially
serious
health
outcomes,
underscoring
need
effective
prevention
treatment
strategies.
Vaccines
are
at
preventing
general
population;
however,
efficacy
often
impaired
in
patients
given
insufficient
response
initial
exposure
and/or
memory
secondary
exposures.
Some
individuals
may
also
have
contraindications
vaccination.
As
such,
additional
protective
measures
needed
bolster
immune
these
populations.
Monoclonal
been
bolstering
system
responses
among
patients;
they
proving
ineffective
against
most
recent
Omicron
strains
(BA.4
BA.5).Several
studies
investigated
pre-
post-prophylaxis
COVID-19.
Historical
evidence
promising;
new
variants
concern
challenging
currently
available
regimens.
Язык: Английский
Resistance Analysis Following Sotrovimab Treatment in Participants with COVID-19 During the Phase III COMET-ICE Study
Future Virology,
Год журнала:
2023,
Номер
18(15), С. 975 - 990
Опубликована: Окт. 1, 2023
Aim:
Sotrovimab
is
an
engineered
human
monoclonal
antibody
that
binds
a
conserved
region
of
the
SARS-CoV-2
spike
protein.
The
COMET-ICE
phase
III
study
evaluated
sotrovimab
for
treatment
mild
to
moderate
COVID-19
in
nonhospitalized
participants
with
≥1
risk
factor
severe
disease
progression.
Materials
&
methods:
We
presence
circulating
variants
concern
or
interest
(VOCs/VOIs)
and
characterized
baseline,
post-baseline
emergent
amino
acid
substitutions
detected
epitope
SARS-CoV-2.
Results:
None
sotrovimab-treated
baseline
substitutions,
1
48
met
primary
clinical
endpoint
Conclusion:
Overall,
progression
was
not
associated
identified
VOC/VOI
participants.
Язык: Английский
Real-World Effectiveness of Sotrovimab for the Early Treatment of COVID-19: Evidence from the US National COVID Cohort Collaborative (N3C)
Clinical Drug Investigation,
Год журнала:
2024,
Номер
44(3), С. 183 - 198
Опубликована: Фев. 20, 2024
The
coronavirus
disease
2019
(COVID-19)
pandemic
has
been
an
unprecedented
healthcare
crisis,
one
that
threatened
to
overwhelm
health
systems
and
prompted
urgent
need
for
early
treatment
options
patients
with
mild-to-moderate
COVID-19
at
high
risk
progression
severe
disease.
Randomised
clinical
trials
established
the
safety
efficacy
of
monoclonal
antibodies
(mAbs)
in
pandemic;
vitro
data
subsequently
led
use
mAbs
being
discontinued,
without
clear
evidence
on
how
these
were
linked
outcomes.
In
this
study,
we
describe
compare
real-world
outcomes
treated
sotrovimab
versus
untreated
patients.
Язык: Английский
Host-Directed Adjunctive Therapies in Immunocompromised Patients with Pneumonia
Clinics in Chest Medicine,
Год журнала:
2024,
Номер
46(1), С. 37 - 48
Опубликована: Дек. 9, 2024
Язык: Английский
Sotrovimab in Severe COVID-19 anti-S Seronegative Immunocompromised Patients: Multicenter Retrospective Cohort
Research Square (Research Square),
Год журнала:
2024,
Номер
unknown
Опубликована: Июнь 6, 2024
Abstract
Purpose:
Sotrovimab’s
effectiveness
remains
uncertain
in
severely
immunocompromised
inpatients
with
COVID-19,
particularly
amidst
the
emergence
of
Omicron
subvariants.
Our
study
aimed
to
evaluate
clinical
progress
and
safety
severe
COVID-19
at-risk
treated
sotrovimab.
Methods:
Retrospective
multicentric
cohort
(four
teaching
hospitals
from
Andalusian
Health
System)
that
included
adult
inmunosupression
negative
anti-S
serology
who
received
sotrovimab
December
2021
March
2023.
Primary
outcomes
focused
on
respiratory
progression
(High-flow
oxygen/Invasive
Non-invasive
support
mortality
at
28-day)
while
secondary
variables
encompassed
hospital
stay
duration
readmission
reasons.
Results:
79
patients
were
included,
58.2%
male,
a
median
age
72
years
(P
25-P
75
65-79).
Significant
immunosuppression
factors
hematologic
neoplasms
51.9%
patients,
solid
organ
transplants
17.7%,
13.9%
systemic
autoimmune
diseases.
The
interval
between
symptom
onset
infusion
was
12
days
(P
25-P
75
8-22),
13
13-26).
36.7%
deceased,
32.9%
attributed
directly
COVID-19.
No
adverse
reactions
reported.
Univariate
analysis
linked
severity
admission
(p<0.05).
Patients
distributed
among
dominant
subvariants
across
five
periods:
BA.1
(15%),
BA.2
(25%),
BA.3
(31.3%),
BQ.1
(16.3%),
XBB.1.5
(11.4%).
Conclusions
The
underscores
need
for
further
investigations
establish
sotrovimab's
efficacy
cases
immunocompromise.
Early
treatment
initiation
may
be
crucial
considering
potential
limitations
its
use
advanced
forms.
Язык: Английский
Clinical practice guideline supported administration of monoclonal antibody therapy for high-risk patients with COVID-19: Experience of a quaternary care centre
Journal of the Association of Medical Microbiology and Infectious Disease Canada,
Год журнала:
2024,
Номер
unknown
Опубликована: Сен. 3, 2024
Background:
Immunocompromised
patients
remain
at
risk
of
progression
to
severe
COVID-19
disease.
Methods:
We
describe
clinical
COVID-19-related
outcomes
after
administration
anti-SARS-CoV-2
monoclonal
antibodies
(mAb)
following
institutional
practice
guidelines
(CPGs)
in
205
high-risk
between
November
2021
and
April
2022
a
Canadian
quaternary
care
centre.
Results:
Median
patient
age
was
59
years;
102
(50%)
were
female.
Eighty-two
(40%)
transplant
recipients,
47
(23%)
had
hematologic
malignancies,
25
(12%)
solid
organ
51
(25%)
another
indication.
Forty-eight
received
fewer
than
two
doses
vaccines.
The
majority
(80%)
mild
disease
presentation
with
14%
moderate
6%
severe.
time
from
symptom
onset
mAb
3
days
(IQR
2.0-5.5
days).
Of
those
who
as
outpatients,
90
(93%)
favourable
(no
hospitalizations
or
death
within
months).
inpatients,
93
(86%)
(discharged
without
re-admission
death),
4%
re-admitted,
10%
died.
In
logistic
regression
analysis,
only
severity
associated
unfavourable
outcomes.
Fewer
vaccine
not
outcomes,
suggesting
potential
benefit
among
the
under-vaccinated.
There
significant
difference
adherence
CPGs
outpatients
versus
inpatients
(adherent
for
85%
58%,
p<0.001),
where
non-adherence
occurred
cases
Conclusion:
CPG-supported
management
may
be
useful
model
guide
future
therapies.
Язык: Английский
Clinical experience in the treatment of COVID-19 with monoclonal antibodies in solid organ transplant recipients
Revista Española de Quimioterapia,
Год журнала:
2023,
Номер
36(Suppl1), С. 25 - 28
Опубликована: Ноя. 24, 2023
Solid
organ
transplant
(SOT)
recipients
are
at
high
risk
for
complications
from
coronavirus
disease
2019
(COVID-19).
SOT
mount
lower
immunological
responses
to
vaccines
than
general
population
and
breakthrough
COVID-19
infections.
Passive
immunotherapy
in
the
form
of
anti-Spike
monoclonal
antibodies
(MoAbs)
may
be
an
alternative
prophylaxis
treatment
these
patients.
SARS-CoV-2
has
evolved
by
accumulating
resistance
mutations
that
have
escaped
neutralizing
action
most
MoAbs.
However,
MoAbs
directed
more
conserved
epitopes
maintain
effector
functions
could
efficacy
According
published
data,
with
low
anti-spike
antibody
vaccination
benefit
use
pre-exposure
prophylaxis,
mild
moderate
severe
less
15
days
symptom
duration
oxygen
requirements.
Combination
therapy
effective
monotherapy
mild-to-moderate
infection.
Язык: Английский