Experts suggest COVID-19 prevention drug for immunocompromised patients
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Key takeaways:
- The Infectious Diseases Society of America has suggested providing a COVID-19 prevention drug to immunocompromised patients.
- The FDA approved pemivibart earlier this year for people aged 12 years or older.
In new guidance, the Infectious Diseases Society of America suggested that immunocompromised patients take the monoclonal antibody pemivibart as pre-exposure prophylaxis to prevent severe COVID-19.
Specifically, the IDSA said pemivibart should be considered for moderately or severely immunocompromised adolescents or adults who are at risk for severe COVID-19 “when predominant regional variants are susceptible to the agent.”
“The anticipated benefit is likely greatest in people who are the most immunocompromised because they have the highest risk of inadequate immune response and progression to severe disease,” the authors of the new guidance wrote.
“Health care professionals need every tool available to protect their most vulnerable patients from the very real risks COVID-19 continues to pose,” lead author Adarsh Bhimraj, MD, FIDSA, director of the infectious diseases education and fellowship programs at Houston Methodist Hospital, said in a press release issued by the IDSA. “IDSA’s guideline update will help clinicians make the right decisions for their patients’ health and well-being.”
In March, the FDA authorized pemivibart for emergency use in moderately or severely immunocompromised patients aged 12 years or older who are not infected with SARS-CoV-2 and have not been recently exposed to someone with the virus. It is the only FDA-approved medicine for COVID-19 PrEP.
An earlier COVID-19 PrEP medication, tixagevimab/cilgavimab, was withdrawn from the market in January 2023 because of reduced efficacy against new variants.
The IDSA’s suggestion was based on pemivibart’s demonstrated ability to protect against omicron subvariants of SARS-CoV-2, but Bhimraj and colleagues noted that the emergence of new subvariants could impact its effectiveness.
Researchers from Columbia University reported this week that pemivibart “has lost substantial neutralizing activity” against KP.3.11 — the predominant omicron virus currently circulating in the United States — according to the results of lab tests, which they published on the preprint server bioRxiv without peer review.
There are indications that COVID-19 is on the rise, including CDC surveillance data that show a “very high” level of SARS-CoV-2 viral activity in U.S. wastewater.
[Editor’s note: This story was updated Aug. 23 to reflect that the guidelines suggest — rather than recommend — the use of pemivibart in moderately or severely immunocompromised patients at risk for severe COVID-19. The IDSA makes a distinction between the two terms when it comes to the strength of its guidance, a spokesperson said.]
References:
- CDC. Variant proportions. https://covid.cdc.gov/covid-data-tracker/#variant-proportions. Last updated Aug. 17, 2024. Accessed Aug. 21, 2024.
- CDC. Wastewater COVID-19 national and regional trends. https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html. Last updated Aug. 15, 2024. Accessed Aug. 21, 2024.
- IDSA. IDSA guidelines on the treatment and management of patients with COVID-19. https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/#Recommendation:NeutralizingAntibodiesforProphylaxisPemivibart. Last updated Aug. 12, 2024. Accessed Aug. 21, 2024.
- IDSA suggests new preventive COVID-19 agent. https://www.idsociety.org/news--publications-new/articles/2024/idsa-suggests-new-preventive-covid-19-agent/. Published Aug. 20, 2024. Accessed Aug. 21, 2024.
- Wang Q, et al. bioRxiv. 2024;doi:10.1101/2024.08.12.607496.
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