Evusheld impactful at reducing COVID-19 infections, improving outcomes
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PHILADELPHIA — COVID-19 infections in patients who receive tixagevimab/cilgavimab are “infrequent,” and “mild in severity,” according to early data presented at ACR Convergence 2022.
“We report our reassuring experience with Evusheld pre-exposure prophylaxis in high-risk patients, the vast majority of whom were B-cell depleted,” Cassandra Calabrese, DO, assistant professor of medicine in the department of rheumatic and immunologic disease, and the department of infectious disease, at the Cleveland Clinic, told Healio.
To investigate the rate and severity of COVID-19 infections in B-cell depleted patients who had received tixagevimab/cilgavimab (Evusheld, AstraZeneca), Calabrese and colleagues conducted a review of records. Researchers collected pharmacy records from a single, large-scale health care system and searched for patients who met the requirements for receiving tixagevimab/cilgavimab. The criteria for receiving tixagevimab/cilgavimab had been instituted by the Cleveland Clinic COVID-19 Pharmacy & Therapeutics subcommittee. Patients who met the criteria and who were later diagnosed with COVID-19 were eligible for the analysis.
Electronic medical records were reviewed manually for all included patients. The researchers analyzed data on COVID-19 infection, vaccinations and infection outcomes. These were classified according to an eight-point scale put forth by NIH.
The analysis included 417 patients with immune-mediated inflammatory diseases who received tixagevimab/cilgavimab between Jan. 18 and May 28. All included patients were previously vaccinated against COVID-19. According to the researchers, 3% experienced a breakthrough COVID-19 infection. Most patients described a mild case of COVID-19 and required only home care, Calabrese said. One patient was hospitalized and received high-flow oxygen. There were no deaths in the cohort.
“We observed a low rate of breakthrough, and those who did break through had favorable outcomes,” Calabrese said. “Important to note is that most breakthrough cases received standard-of-care COVID treatment with antivirals, monoclonals or both. The number of circulation variants of concern for which Evusheld is ineffective against is rising, and we should continue to aggressively manage high risk outpatients with oral antivirals and [monoclonal antibodies].”
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Calabrese C. Abstract #0779. Presented at: ACR Convergence 2022; Nov. 11-14, 2022, Philadelphia (hybrid meeting).
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