tetano
Editor, Senior Moderator
Intern Med
. 2024 Jan 2.
doi: 10.2169/internalmedicine.2900-23. Online ahead of print. Clinical Efficacy of Imdevimab/Casirivimab for Persistent Omicron SARS-CoV-2 Infection in Patients with Hematological Malignancies
Masao Hagihara[SUP] 1 [/SUP], Hiroyoshi Hayashi[SUP] 1 [/SUP], Shiori Nakashima[SUP] 1 [/SUP], Yui Imai[SUP] 1 [/SUP], Hirofumi Nakano[SUP] 1 [/SUP], Tomoyuki Uchida[SUP] 1 [/SUP], Morihiro Inoue[SUP] 1 [/SUP], Yuko Sakai-Tagawa[SUP] 2 [/SUP], Mutsumi Ito[SUP] 2 [/SUP], Seiya Yamayoshi[SUP] 2 3 [/SUP], Kiyoko Iwatsuki-Horimoto[SUP] 2 [/SUP], Yutaka Suzuki[SUP] 4 [/SUP], Yoshihiro Kawaoka[SUP] 2 3 5 6 [/SUP]
Affiliations
Objective Prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been reported in immunocompromised patients, as they poorly develop antibodies against SARS-CoV-2. We conducted a clinical trial to determine the efficacy of Imdevimab/Casirivimab (Imde/Casiri), an anti-viral monoclonal antibody (mAb), for prolonged infection at our institution. Methods Nine patients with hematological malignancies (six with malignant lymphoma and three with multiple myeloma) in our institution presented with coronavirus disease 2019 caused by SARS-CoV-2 omicron variants (one, five, and one with BA.2, BA.5, and BF.7, respectively; two undetermined). Although not all nine patients developed severe disease, viral mRNA was detected in all patients after treatment with remdesivir or molnupiravir. Imde/casiri was infused 11-49 days after the disease onset. Results Within seven days of infusion, viral RNA was undetectable in five of the nine cases. Because all seven viruses isolated from patients whose viral RNA became undetectable showed low or no sensitivity to this monoclonal antibody cocktail, the disappearance of viral RNA in these cases may not be attributable to the antibody cocktail. Conclusion It may be worth considering the use of monoclonal antibodies that show some activity against these virus variants to treat persistent SARS-CoV-2 infection in immunocompromised patients.
Keywords: COVID-19; Imdevimab/Casirivimab; hematological malignancies; mRNA; persistent infection.
. 2024 Jan 2.
doi: 10.2169/internalmedicine.2900-23. Online ahead of print. Clinical Efficacy of Imdevimab/Casirivimab for Persistent Omicron SARS-CoV-2 Infection in Patients with Hematological Malignancies
Masao Hagihara[SUP] 1 [/SUP], Hiroyoshi Hayashi[SUP] 1 [/SUP], Shiori Nakashima[SUP] 1 [/SUP], Yui Imai[SUP] 1 [/SUP], Hirofumi Nakano[SUP] 1 [/SUP], Tomoyuki Uchida[SUP] 1 [/SUP], Morihiro Inoue[SUP] 1 [/SUP], Yuko Sakai-Tagawa[SUP] 2 [/SUP], Mutsumi Ito[SUP] 2 [/SUP], Seiya Yamayoshi[SUP] 2 3 [/SUP], Kiyoko Iwatsuki-Horimoto[SUP] 2 [/SUP], Yutaka Suzuki[SUP] 4 [/SUP], Yoshihiro Kawaoka[SUP] 2 3 5 6 [/SUP]
Affiliations
- PMID: 38171874
- DOI: 10.2169/internalmedicine.2900-23
Objective Prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been reported in immunocompromised patients, as they poorly develop antibodies against SARS-CoV-2. We conducted a clinical trial to determine the efficacy of Imdevimab/Casirivimab (Imde/Casiri), an anti-viral monoclonal antibody (mAb), for prolonged infection at our institution. Methods Nine patients with hematological malignancies (six with malignant lymphoma and three with multiple myeloma) in our institution presented with coronavirus disease 2019 caused by SARS-CoV-2 omicron variants (one, five, and one with BA.2, BA.5, and BF.7, respectively; two undetermined). Although not all nine patients developed severe disease, viral mRNA was detected in all patients after treatment with remdesivir or molnupiravir. Imde/casiri was infused 11-49 days after the disease onset. Results Within seven days of infusion, viral RNA was undetectable in five of the nine cases. Because all seven viruses isolated from patients whose viral RNA became undetectable showed low or no sensitivity to this monoclonal antibody cocktail, the disappearance of viral RNA in these cases may not be attributable to the antibody cocktail. Conclusion It may be worth considering the use of monoclonal antibodies that show some activity against these virus variants to treat persistent SARS-CoV-2 infection in immunocompromised patients.
Keywords: COVID-19; Imdevimab/Casirivimab; hematological malignancies; mRNA; persistent infection.