Effectiveness of Evusheld in Immunocompromised Patients: Propensity Score-Matched Analysis.

ABSTRACT

BACKGROUND: Tixagevimab and Cilgavimab, a combined monoclonal antibody (Evusheld) was granted emergency use authorization for SARS-CoV-2 preexposure prophylaxis in individuals with moderate to severe immunocompromising condition. In this study we used population-based real-world data to evaluate the effectiveness of Evusheld in immunocompromised patients. METHODS: Using the computerized database of the largest healthcare provider in Israel, we identified all adult immunocompromised patients who were eligible to receive Evusheld (the dose used during the study period was 150 mg Tixagevimab and 150 mg Cilgavimab) on 15-February-2022. Patients with a documentation of a prior SARS-CoV-2 infection were excluded. A total of 703 patients who received Evusheld were propensity score-matched, using a ratio of 14, with 2812 patients who have not received Evusheld (control group). Patients were followed through 30-June-2022 for up to 90-days for the first documentation of SARS-CoV-2 infection and COVID-19 related hospitalization. RESULTS: Overall, 72 patients in the Evusheld group and 377 patients in the control group had SARS-CoV-2 infection, reflecting and incidence rate of 4.18 and 5.64 per 100 person-months, respectively. HR was 0.75(95%CI,0.58-0.96) for SARS-CoV-2 infection, and 0.41(0.19-0.89) for COVID-19 related hospitalization in the Evusheld group compared to the control group. The magnitude of relative risks reduction of each outcome was greater in non-obese patients (P for interaction = 0.020 and 0.045, respectively). CONCLUSION: This study suggests that Evusheld (150 mg Tixagevimab and 150 mg Cilgavimab) is effective in reducing the risk of SARS-CoV-2 infection and COVID-19 hospitalization in immunocompromised patients. The effectiveness of this dose appears to be greater in non-obese patients.