Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individuals
Abstract Tixagevimab–cilgavimab was available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevention from December 2021 to January 2023, with dosing changes to reflect circulating variants. In a retrospective analysis of 597 immunocompromised individuals, incidence of SARS-CoV-2...
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Nature Portfolio
2025-05-01
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| Online Access: | https://doi.org/10.1038/s41598-025-02240-3 |
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| author | Daniela Dluzynski Paddy Ssentongo Cory M. Hale Shareef K. Shaheen Natella Maglakelidze Jeffrey M. Sivik Maria Paula Henao Vernon M. Chinchilli Catharine I. Paules |
| author_facet | Daniela Dluzynski Paddy Ssentongo Cory M. Hale Shareef K. Shaheen Natella Maglakelidze Jeffrey M. Sivik Maria Paula Henao Vernon M. Chinchilli Catharine I. Paules |
| author_sort | Daniela Dluzynski |
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| description | Abstract Tixagevimab–cilgavimab was available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevention from December 2021 to January 2023, with dosing changes to reflect circulating variants. In a retrospective analysis of 597 immunocompromised individuals, incidence of SARS-CoV-2 infection was compared between those who did and did not receive tixagevimab–cilgavimab. A proportional hazards regression model with a time-dependent regressor for tixagevimab–cilgavimab dose was applied to assess cumulative doses. Secondary analyses were performed in hematopoietic stem cell transplant (HSCT) and chimeric antigen receptor (CAR)-T cell therapy recipients. There was no difference in SARS-CoV-2 infections between tixagevimab–cilgavimab recipients and controls (p = 0.27). There was a trend towards protection with increasing dose from 150 (HR 0.83, CI 0.50–1.38) to 600 mg (HR 0.48, CI 0.06–3.63) when truncating data on November 1st, 2022, which was also seen in HSCT or CAR-T cell therapy recipients, 150 mg (HR 0.71, CI 0.31–1.65) to 600 mg (HR 0.26, CI 0.01–7.47). This was most evident in immunocompromised individuals when variants neutralized by tixagevimab–cilgavimab in vitro were circulating; effectiveness 74%. Supports a proof of concept for monoclonal antibodies in immunocompromised individuals as a prevention strategy against novel viruses. |
| format | Article |
| id | doaj-art-3abdd51dffd5496098cc8e67a7bb05b4 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-3abdd51dffd5496098cc8e67a7bb05b42025-08-20T03:48:15ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-02240-3Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individualsDaniela Dluzynski0Paddy Ssentongo1Cory M. Hale2Shareef K. Shaheen3Natella Maglakelidze4Jeffrey M. Sivik5Maria Paula Henao6Vernon M. Chinchilli7Catharine I. Paules8Penn State College of MedicineDivision of Infectious Diseases, Department of Medicine, Penn State Health Milton S. Hershey Medical CenterDepartment of Pharmacy, Penn State Health Milton S. Hershey Medical CenterPenn State College of MedicinePenn State College of MedicineDepartment of Pharmacy, Penn State Health Milton S. Hershey Medical CenterDivision of Allergy and Immunology, Department of Medicine, Penn State Health Milton S. Hershey Medical CenterDepartment of Public Health Sciences, Penn State College of MedicineDivision of Infectious Diseases, Department of Medicine, Penn State Health Milton S. Hershey Medical CenterAbstract Tixagevimab–cilgavimab was available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevention from December 2021 to January 2023, with dosing changes to reflect circulating variants. In a retrospective analysis of 597 immunocompromised individuals, incidence of SARS-CoV-2 infection was compared between those who did and did not receive tixagevimab–cilgavimab. A proportional hazards regression model with a time-dependent regressor for tixagevimab–cilgavimab dose was applied to assess cumulative doses. Secondary analyses were performed in hematopoietic stem cell transplant (HSCT) and chimeric antigen receptor (CAR)-T cell therapy recipients. There was no difference in SARS-CoV-2 infections between tixagevimab–cilgavimab recipients and controls (p = 0.27). There was a trend towards protection with increasing dose from 150 (HR 0.83, CI 0.50–1.38) to 600 mg (HR 0.48, CI 0.06–3.63) when truncating data on November 1st, 2022, which was also seen in HSCT or CAR-T cell therapy recipients, 150 mg (HR 0.71, CI 0.31–1.65) to 600 mg (HR 0.26, CI 0.01–7.47). This was most evident in immunocompromised individuals when variants neutralized by tixagevimab–cilgavimab in vitro were circulating; effectiveness 74%. Supports a proof of concept for monoclonal antibodies in immunocompromised individuals as a prevention strategy against novel viruses.https://doi.org/10.1038/s41598-025-02240-3COVID-19Tixagevimab–cilgavimabMonoclonal antibodyHematopoietic stem cell transplantChimeric antigen receptor (CAR)-T cell therapy |
| spellingShingle | Daniela Dluzynski Paddy Ssentongo Cory M. Hale Shareef K. Shaheen Natella Maglakelidze Jeffrey M. Sivik Maria Paula Henao Vernon M. Chinchilli Catharine I. Paules Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individuals Scientific Reports COVID-19 Tixagevimab–cilgavimab Monoclonal antibody Hematopoietic stem cell transplant Chimeric antigen receptor (CAR)-T cell therapy |
| title | Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individuals |
| title_full | Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individuals |
| title_fullStr | Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individuals |
| title_full_unstemmed | Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individuals |
| title_short | Dose-dependent impact of tixagevimab–cilgavimab as primary prevention against SARS-CoV-2 in immunocompromised individuals |
| title_sort | dose dependent impact of tixagevimab cilgavimab as primary prevention against sars cov 2 in immunocompromised individuals |
| topic | COVID-19 Tixagevimab–cilgavimab Monoclonal antibody Hematopoietic stem cell transplant Chimeric antigen receptor (CAR)-T cell therapy |
| url | https://doi.org/10.1038/s41598-025-02240-3 |
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