Year 2022 / Volume 114 / Number 12
Letter
Protective measures against Omicron could be more effective than Evusheld® in liver transplant recipients

769-770

DOI: 10.17235/reed.2022.9058/2022

Aitor Odriozola Herrán, José Ignacio Fortea Ormaechea, Antonio Cuadrado, Ángela Puente Sánchez, Jeffrey V. Lazarus, Javier Crespo, Emilio Fábrega,

Abstract
Evusheld (the combination of cilgavimab and tixagevimab, two long-lasting monoclonal antibodies against SARS-CoV-2) has been approved by the FDA as a pre-exposure treatment for COVID-19 in immunocompromised patients older than 12 years. However, this monoclonal antibody has been developed from SARS-CoV-2 variants that were predominant at the beginning of the pandemic, when Ómicron was not prevalent. Compared with other solid organ transplant recipients, liver transplant recipients have shown an excellent immune response to standard vaccination with three doses of the SARS-CoV-2 vaccine. In addition, this population has shown very good adherence to protective measures for the transmission of COVID-19 infection. Several studies have shown that the use of Evusheld is less effective against Ómicron than against other variants of SARS-CoV-2. In addition, in the post-hoc analysis, it appears to be a drug that increases cardiovascular risk. For these reasons, we believe that in liver transplant recipients is essential to prioritize vaccination and protective measures, rather than the use of Evusheld as pre-exposure prophylaxis.
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References
1. Boschi C, Colson P, Bancod A, Moal V, La Scola B. Omicron variant escapes therapeutic mAbs including recently released Evusheld ®, contrary to eight prior main VOC. Clin Infect Dis. 2022 Feb 16:ciac143. doi: 10.1093/cid/ciac143. Epub ahead of print. PMID: 35171987.
2. Odriozola A, Lamadrid-Perojo P, Cuadrado A, San Segundo D, Del Barrio M, Fortea JI, Puente A, Amigo L, Fernández-Santiago R, Castillo F, Achalandabaso M, Andrés Echeverri J, Rodríguez-Sanjuan JC, López-Hoyos M, Crespo J, Fábrega E. Immune Response After a Third Dose of the mRNA-1273 SARS-CoV-2 Vaccine in Liver Transplant Recipients. Transplantation. 2022 Mar 23. doi: 10.1097/TP.0000000000004147. Epub ahead of print. PMID: 35323163.
3. US Food and Drug Administration. Fact sheet for health care providers: Emergency Use Authorization for Evusheld (tixagevimab co-packaged with cilgavimab). Accessed December 21, 2021.
4. Odriozola A, San Segundo D, Cuadrado A, Hernáez T, Escrich V, Fortea JI, Martínez Á, Puente Á, Lapeña B, Del Barrio M, López-Hoyos M, Crespo J, Fábrega E. SARS-CoV-2 and Liver Transplant: How Has It Behaved in This Sixth Wave? Transplantation. 2022 Apr 8. doi: 10.1097/TP.0000000000004157. Epub ahead of print. PMID: 35394994.
5. Cuadrado A, Gaite LM, Odriozola A, Oloriz R, Herrera S, Fortea JI, Amigo L, Anderson EJ, Artal JA, Crespo J, Fábrega E. Impact of the COVID-19 lockdown on liver transplant recipients. A single center observational study. Rev Esp Enferm Dig. 2021 Sep 2. doi: 10.17235/reed.2021.8173/2021. Epub ahead of print. PMID: 34470450.
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Odriozola Herrán A, Fortea Ormaechea J, Cuadrado A, Puente Sánchez Á, Lazarus J, Crespo J, et all. Protective measures against Omicron could be more effective than Evusheld® in liver transplant recipients. 9058/2022


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Publication history

Received: 05/07/2022

Accepted: 28/07/2022

Online First: 31/08/2022

Published: 12/12/2022

Article Online First time: 57 days

Article editing time: 160 days


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