Pre-exposure prophylaxis with tixagevimab and cilgavimab (Evusheld) for COVID-19 among 1112 severely immunocompromised patients.


Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 18 05 2022
revised: 15 07 2022
accepted: 16 07 2022
pubmed: 5 8 2022
medline: 25 11 2022
entrez: 4 8 2022
Statut: ppublish

Résumé

Immunocompromised patients have an increased risk of a severe form of COVID-19. The clinical efficacy of the tixagevimab/cilgavimab monoclonal antibody combination as pre-exposure prophylaxis against BA.1 and BA.2 SARS-CoV-2 Omicron sublineages is unknown. We aimed to describe the incidence and outcomes of COVID-19 among immunocompromised patients receiving tixagevimab/cilgavimab as preexposure prophylaxis during the Omicron wave in France. This was an observational multicentre cohort study of immunocompromised patients receiving tixagevimab/cilgavimab as preexposure prophylaxis between December 28, 2021 and March 31, 2022. Patients received tixagevimab/cilgavimab 150/150 mg intramuscularly if they had impaired vaccine response and a high risk of severe form of COVID-19. Tixagevimab/cilgavimab was administered to 1112 immunocompromised patients. After a median (range) follow-up of 63 (49-73) days, COVID-19 was confirmed in 49/1112 (4.4%) ≥5 days after treatment. During the study period, mean weekly incidence rate was 1669 in 100 000 inhabitants in Ile-de-France and 530 in 100 000 among patients who received tixagevimab/cilgavimab prophylaxis. Among infected patients, 43/49 (88%) had a mild-to-moderate form and 6/49 (12%) had a moderate-to-severe form of COVID-19. Patients with moderate-to-severe illnesses were less likely to have received early therapies than patients with mild forms (53.5% vs. 16.7% respectively) and 2/49 (4%) patients died from COVID-19. Our study reported a low rate of infections and severe illnesses among immunocompromised patients treated with tixagevimab/cilgavimab. A global preventive strategy including vaccines, preexposure prophylaxis with monoclonal antibodies, and early therapies might be effective to prevent severe forms of COVID-19 among severely immunocompromised patients.

Identifiants

pubmed: 35926762
pii: S1198-743X(22)00383-4
doi: 10.1016/j.cmi.2022.07.015
pmc: PMC9340091
pii:
doi:

Substances chimiques

tixagevimab 0
cilgavimab 1KUR4BN70F
Antibodies, Monoclonal 0

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1654.e1-1654.e4

Informations de copyright

Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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Auteurs

Yann Nguyen (Y)

Service de Médecine Interne, Hôpital Cochin, Centre de référence maladies systémiques auto-immunes rares d'Ile-de-France, Assistance Publique, Hôpitaux de Paris (AP-HP), Centre, Université Paris Cité, Paris, France.

Adrien Flahault (A)

Service de Néphrologie, Hôpital Européen Georges Pompidou, France.

Nathalie Chavarot (N)

Service de Transplantation Rénale Adulte et Néphrologie, Hôpital Necker Enfants Malades, France.

Cléa Melenotte (C)

Service de Maladies Infectieuses, Hôpital Necker, France.

Morgane Cheminant (M)

Service d'Hématologie, Hôpital Necker, France.

Paul Deschamps (P)

Service d'Hématologie, Hôpital Cochin, France.

Nicolas Carlier (N)

Service de Pneumologie, Hôpital Cochin, France.

Emmanuel Lafont (E)

Service de Médecine Interne, Hôpital Européen Georges Pompidou, France.

Marion Thomas (M)

Service de Rhumatologie, Hôpital Cochin, France.

Edouard Flamarion (E)

Service de Médecine Interne, Hôpital Européen Georges Pompidou, France.

David Lebeaux (D)

Equipe mobile d'Infectiologie, Hôpital Européen Georges Pompidou, France.

Caroline Charlier (C)

Equipe Mobile d'Infectiologie, Hôpital Cochin, France.

Anne Rachline (A)

Service d'Immunologie Clinique, Hôpital Hôtel Dieu, France.

Corinne Guérin (C)

Service de Pharmacie, Hôpital Cochin, France.

Robert Ratiney (R)

Service de Pharmacie, Hôpital Necker Enfants Malades, France.

Justine Touchard (J)

Service de Pharmacie, Hôpital Européen Georges Pompidou, France.

Hélène Péré (H)

Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, France.

Flore Rozenberg (F)

Laboratoire de Virologie, Hôpital Cochin, France.

Fanny Lanternier (F)

Service de Maladies Infectieuses, Hôpital Necker, France.

Jean-Benoît Arlet (JB)

Service de Médecine Interne, Hôpital Européen Georges Pompidou, France.

Jérôme Avouac (J)

Service de Rhumatologie, Hôpital Cochin, France.

Véronique Boussaud (V)

Service de Pneumologie, Hôpital Cochin, France.

Romain Guillemain (R)

Service de Chirurgie Cardiaque, Hôpital Européen Georges Pompidou, AP-HP Centre, Université Paris Cité, Paris, France.

Marguerite Vignon (M)

Service d'Hématologie, Hôpital Cochin, France.

Eric Thervet (E)

Service de Néphrologie, Hôpital Européen Georges Pompidou, France.

Anne Scemla (A)

Service de Transplantation Rénale Adulte et Néphrologie, Hôpital Necker Enfants Malades, France.

Laurence Weiss (L)

Service d'Immunologie Clinique, Hôpital Hôtel Dieu, France.

Luc Mouthon (L)

Service de Médecine Interne, Hôpital Cochin, Centre de référence maladies systémiques auto-immunes rares d'Ile-de-France, Assistance Publique, Hôpitaux de Paris (AP-HP), Centre, Université Paris Cité, Paris, France. Electronic address: luc.mouthon@aphp.fr.

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