Preventing Severe COVID-19 with Tixagevimab-Cilgavimab in Hematological Patients Treated with Anti-CD20 Monoclonal Antibodies: An International Multicenter Study

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2024年12月9日

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Hovav Azuly,
Tali Shafat,
Daniel Grupel,
Tzvika Porges,
Ran Abuhasira,
Ana Belkin,
Ofir Deri,
Yonatan Oster,
Shadi Zahran,
Ehud Horwitz,
Netanel A. Horowitz,
Hazim Khatib,
Marjorie Vieira Batista,
Anita Cassoli Cortez,
Tal Brosh-Nissimov,
Yafit Segman,
Linor Ishay,
Regev Cohen,
Alaa Atamna,
Amy Spallone,
Roy F. Chemaly,
Juan Carlos Ramos,
Michal Chowers,
Evgeny Rogozin,
Noga Carmi Oren,
Şiran Keske,
Orit Wolfovitz Barchad,
Lior Nesher,
Tali Shafat,
Marjorie Vieira Batista,
Alaa Atamna,
Amy Spallone,
Roy F. Chemaly,
Juan Carlos Ramos,
Şiran Keske,
Lior Nesher

摘要

Introduction

Despite the declining public health emergency status, COVID-19 still poses significant risks, especially for immunocompromised individuals. We aimed to evaluate the effectiveness of tixagevimab-cilgavimab (T-C) prophylaxis in preventing severe COVID-19 in patients with hematologic malignancies (HM) treated with anti-CD20 therapy during the early Omicron variant phase of the pandemic.

Methods

The European Society of Clinical Microbiology and Infectious Diseases Study Group for Respiratory Viruses (ESGREV) conducted a multicenter retrospective cohort study involving 15 centers from 5 countries. The study included 749 patients with HM treated with anti-CD20 between February 15 and June 30, 2022, comparing 215 who received T-C prophylaxis to 534 who did not.

Results

The study revealed a significant reduction in the risk of COVID-19 among patients who received T-C prophylaxis compared to those who did not (11.2% vs 23.4%, p < 0.001), with hazard ratio (HR) of 0.40 (95% CI 0.26–0.63), adjusted for age, sex, vaccination status, baseline HM malignancy and type of anti-CD-20. We also demonstrated a reduction for severe-critical diseases within all study populations, 1.4% vs 5.2%, p = 0.017, HR 0.26 (95% CI 0.08–0.84).

Conclusion

T-C prophylaxis effectively prevented COVID-19 and severe-critical COVID-19 in patients with HM treated with anti-CD20 monoclonal antibodies during the early Omicron variant phase of the pandemic. Even though T-C is ineffective against current variants, these findings highlight the importance of additional protective measures and the continued development of monoclonal antibodies to protect immunocompromised individuals to mitigate the impact of COVID-19 and other respiratory viral diseases.