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Pre-exposure prophylaxis with Evusheld™ elicits limited neutralizing activity against the omicron variant in kidney transplant patients
Ilies Benotmane; Aur&eacutelie Velay; Olivier Thaunant; Gabriela Gautier-Vargas; Jérôme Olagne; Samira Fafi-Kremer; Sophie Caillard.
  • Ilies Benotmane; Hopitaux universitaires de Strasbourg
  • Aur&eacutelie Velay; Hopitaux Universitaires de Strasbourg
  • Olivier Thaunant; Hospices Civils de Lyon
  • Gabriela Gautier-Vargas; Hopitaux Universitaires de Strasbourg
  • Jérôme Olagne; Hopitaux Universitaires de Strasbourg
  • Samira Fafi-Kremer; Hopitaux Universitaires de Strasbourg
  • Sophie Caillard; Hopitaux Universitaires de Strasbourg
Preprint Dans Anglais | medRxiv | ID: ppmedrxiv-22272669
ABSTRACT
The combination of cilgavimab-tixagevimab (Evusheld, Astra Zeneca) became the mainstay for protecting transplant recipients with poor response to vaccination against the omicron variant. Serum neutralizing capacity against SARS-CoV-2 is positively associated with protection against severe forms of Covid-19. Both anti-RBD IgG titers and neutralizing antibody titers against the omicron BA.1 variant were measured in serum samples collected from 63 adult kidney transplant recipients who received prophylactic injections of Evusheld. Patients who received prophylactic Ronapreve (casirivimab-imdevimab, n = 39) and those who were infected with SARS-CoV-2 during the fifth wave of the pandemic (n = 14) served as negative and positive controls, respectively. After a median interval from injection of 29 days (interquartile range 29-33 days), only 9.5% of patients who received Evusheld were able to neutralize the omicron variant compared to 71% of patients who were infected with SARS-CoV-2 and 2.6% of those who received Ronapreve. Interestingly, convalescent patients displayed higher levels of neutralizing antibodies than those who received EvusheldTM (median 2.3 log IC50, IQR 1.5-2.7 versus 0.00 log IC50, IQR 0&[ndash] 0.05; p<0.001). A high interindividual variability in anti-RBD IgG titers was observed after Evusheld (range 262-7032 BAU/mL). This variability was largely explained by the patientsbody mass index, which showed an inverse correlation with anti-RBD IgG titers. These findings suggest that Evusheld given at a dose of 300 mg is not sufficient to elicit an anti-RDB titer that confers in vivo neutralizing activity and support recent FDA recommendations, derived from in vitro models, regarding the need to increase the dose of Evusheld
Texte intégral: Disponible Collection: Preprints Base de données: medRxiv Type d'étude: Étude pronostique Les sujets: Vaccins / Variantes langue: Anglais Année: 2022 Type de document: Preprint
Texte intégral: Disponible Collection: Preprints Base de données: medRxiv Type d'étude: Étude pronostique Les sujets: Vaccins / Variantes langue: Anglais Année: 2022 Type de document: Preprint