The JAMA Network recently published an original investigation that found that a single intravenous dose of sotrovimab, an anti-SARS-CoV-2 monoclonal antibody (mAbs) treatment, resulted in a statistically significant reduction in the proportion of patients who experienced a composite outcome of all-cause hospitalization longer than 24 hours or death through day 29 (1% versus 6%, respectively; adjusted relative risk, 0.21).
This is an important finding since older patients and those with comorbidities infected with SARS-CoV-2 may be at increased risk of hospitalization and death.
Although sotrovimab also significantly reduced viral load at day 8 (consistent with the drug’s mode of action including virus neutralization and Fc-mediated effector function), the magnitude of these reductions was modest.
These data suggest that changes in nasopharyngeal viral load alone may not be a good predictor of clinical disease course with sotrovimab treatment.
This finding is consistent with the lack of evidence indicating that antiviral activity in the lungs can be accurately measured with a nasopharyngeal RT-PCR test due to the anatomic site and the fact that viral RNA can persist in the absence of the replication-competent virus.
The study was conducted at 57 sites in Brazil, Canada, Peru, Spain and the United States from August 2020 to March 11, 2021, with follow-up data collected through April 8, 2021.
These dates indicate that the Delta and Omicron virus variants have not been evaluated.
Corresponding author: Adrienne E. Shapiro, MD, Ph.D., Fred Hutchinson Cancer Research Center: [email protected].
Sotrovimab, known internationally as Xevudy, is a neutralizing mAb cleared by the US FDA for the treatment of high-risk patients to prevent the progression of COVID-19.
More mAb news is posted at PrecisionVaccinations.com/antibody.
Note: This JAMA study has been edited for clarity and organized for mobile readers.