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Effects of Anti-COVID-19 Vaccination and Pre-Exposure Prophylaxis with Tixagevimab-Cilgavimab in Kidney and Liver Transplant Recipients

Angelico, Roberta ; Romano, Francesca ; Coppola, Luigi ; Materazzo, Marco ; Pedini, Domiziana ; Santicchia, Maria Sara ; Cacciola, Roberto ; Toti, Luca ; Sarmati, Loredana ; Tisone, Giuseppe

Medicina (Kaunas, Lithuania), 2023-11, Vol.59 (12), p.2101 [Periódico revisado por pares]

Switzerland: MDPI AG

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Título:
Effects of Anti-COVID-19 Vaccination and Pre-Exposure Prophylaxis with Tixagevimab-Cilgavimab in Kidney and Liver Transplant Recipients
Autor: Angelico, Roberta ; Romano, Francesca ; Coppola, Luigi ; Materazzo, Marco ; Pedini, Domiziana ; Santicchia, Maria Sara ; Cacciola, Roberto ; Toti, Luca ; Sarmati, Loredana ; Tisone, Giuseppe
Assuntos: Adult ; Analysis ; anti-SARS-CoV-2 antibodies’ titer ; Antibodies, Monoclonal ; Antibodies, Viral ; Anticoagulants ; Antithymocyte globulin ; Blood ; COVID-19 - prevention & control ; COVID-19 disease ; COVID-19 vaccines ; COVID-19 Vaccines - therapeutic use ; Demographics ; Disease prevention ; Disease transmission ; Ethics ; Health aspects ; Humans ; Immune response ; Infections ; Kidney ; Kidneys ; Liver ; Liver Transplantation ; Liver transplants ; long-active antibody ; Monoclonal antibodies ; Mortality ; Organ transplant recipients ; Pandemics ; Pharmaceutical industry ; Pharmaceuticals ; Pre-Exposure Prophylaxis ; Response rates ; RNA polymerase ; SARS-CoV-2 ; Serology ; Severe acute respiratory syndrome coronavirus 2 ; tixagevimab ; Transplantation ; Vaccination
É parte de: Medicina (Kaunas, Lithuania), 2023-11, Vol.59 (12), p.2101
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: : Underpowered immune response to vaccines against SARS-CoV-2 was observed in solid organ transplant (SOT) recipients. A novel combination of monoclonal antibodies tixagevimab-cilgavimab (TGM/CGM) received authorization as pre-exposure prophylaxis (PrEP) in those with reduced response to vaccine. We aimed to evaluate the response rate to COVID-19 vaccination in kidney transplant (KT), compared to liver transplant (LT) recipients, and the efficacy and safety of PrEP with TGM/CGM. : Between March and November 2022, adult KT and LT recipients who had completed the vaccination schedule (3 doses) were tested for anti-SARS-CoV-2 antibodies titer. SOT recipients with anti-SARS-CoV-2 titer ≥ 100 IU/mL were considered protected against infection, while those with titer < 100 UI/mL were defined non-protected. Patients with inadequate response were invited to PrEP. : In total, 306 patients were enrolled [KT:197 (64.4%), LT:109 (35.6%)]. After the complete scheme of vaccination, 246 (80.3%) patients developed a protective titer, while 60 (19.6%) did not have a protective titer. KT recipients had a lower rate of protective anti-COVID-19 titer compared to LT patients [149 (75.6%) vs. 97 (89.0%), = 0.004]. Recipients with non-protective anti-COVID-19 titer received mainly tacrolimus-based regimen associated with mycophenolate mofetil (MMF) (70%) e steroids (46.7%) as maintenance immunosuppression, while those treated with everolimus were associated with higher protective titer. Of 35 (58.3%) patients who received PrEP, within 12 months, 6 (17.1%) (all KT) developed pauci-symptomatic COVID-19 disease, while 15/25 (60%) of non-responders, who did not receive the prophylaxis, developed COVID-19 disease. After PrEP, hospitalization rate was lower (2.8% vs. 16%), and no adverse events, neither graft loss nor rejection, were observed. : Despite complete COVID-19 vaccination, SOT recipients might be not protected from the SARS-CoV-2 infection, especially after KT. In non-protected SOT patients, the subsequent pre-exposure prophylaxis with combination of monoclonal antibodies (TGM/CGM) might be an efficacy and safe strategy to prevent COVID-19 severe disease and hospitalization.
Editor: Switzerland: MDPI AG
Idioma: Inglês

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Effects of Anti-COVID-19 Vaccination and Pre-Exposure Prophylaxis with Tixagevimab-Cilgavimab in Kidney and Liver Transplant Recipients

Angelico, Roberta ; Romano, Francesca ; Coppola, Luigi ; Materazzo, Marco ; Pedini, Domiziana ; Santicchia, Maria Sara ; Cacciola, Roberto ; Toti, Luca ; Sarmati, Loredana ; Tisone, Giuseppe

Switzerland: MDPI AG

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