Gastroenterología y Hepatología, Hospital Unviersitario Marqués de Valdecilla, Spain.
Gastroenterología y Hepatología, Hospital Universitario Marqués de Valdecilla..
Rev Esp Enferm Dig. 2022 Dec;114(12):769-770. doi: 10.17235/reed.2022.9058/2022.
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.
埃武利单抗（cilgavimab 和 tixagevimab 的组合，两种针对 SARS-CoV-2 的长效单克隆抗体）已获得 FDA 批准，可用于 12 岁以上免疫功能低下的 COVID-19 患者的暴露前治疗。然而，这种单克隆抗体是由大流行初期流行的 SARS-CoV-2 变异株开发的，当时奥密克戎尚未流行。与其他实体器官移植受者相比，肝移植受者对标准接种三剂 SARS-CoV-2 疫苗表现出极好的免疫反应。此外，该人群对 COVID-19 感染传播的保护措施具有非常好的依从性。几项研究表明，与其他 SARS-CoV-2 变异株相比，埃武利单抗对奥密克戎的疗效较差。此外，在事后分析中，它似乎是一种增加心血管风险的药物。基于这些原因，我们认为在肝移植受者中，优先接种疫苗和采取保护措施至关重要，而不是使用埃武利单抗作为暴露前预防。
