Neutralizing monoclonal antibody care aids kidney transplant patients with omicron variant
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Kidney transplant patients infected with COVID-19, including the omicron variant, benefit from neutralizing monoclonal antibody therapy, according to data published in Kidney Medicine.
“Neutralizing monoclonal antibody treatments have shown promising preliminary results in kidney transplant recipients with SARS-CoV-2,” Guillaume Fernandes, MD, from the division of nephrology of Cliniques Universitaires Saint-Luc at Université Catholique de Louvain in Belgium, and colleagues wrote. “However, its efficacy in kidney transplant recipients infected with the emerging omicron variant has not been reported yet.”
In a single-center retrospective study, researchers evaluated the results of 47 kidney transplant recipients (median age was 50 years; 55% were men; 66% had hypertension; 34% had diabetes; 83% received at least two doses of a COVID-19 vaccine) treated with monoclonal antibodies for COVID-19 between June 10, 2021, and Jan. 14, 2022. Thirteen patients were infected with the omicron variant.
Patients were given two different monoclonal antibodies: casirivimab 1,200 mg and imdevimab 1,200 mg (n=16), and sotrovimab 500 mg (n=31).
Researchers measured vaccine-induced humoral responses using an immunoassay detecting antibodies against the spike protein receptor-binding domain.
One mild allergic reaction was reported during casirivimab-imdevimab infusion, and no adverse events were reported. Researchers identified median viral loads at admission and 7 days after monoclonal antibody infusion were 2,110,027 copies/mL and 1,000 copies m/L, respectively. In those infected with the omicron variant, the median viral loads at admission and day 7 were 752,789 copies m/L and 1,353 copies m/L, respectively.
Overall, two patients needed short hospitalization for oxygen supply following monoclonal antibody treatment. None died or were admitted to the ICU within a 30-day follow-up period.
“In conclusion, our study provides reassuring data about the efficacy and safety of neutralizing monoclonal antibody treatment in kidney transplant recipients with mild COVID-19, including those infected with the omicron variant SARS-CoV-2,” Fernandes and colleagues wrote. “Larger controlled studies are required to confirm our observations.”
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