Dataset Information

Engineering monoclonal antibodies for COVID-19 prophylaxis.

ABSTRACT: The therapeutic and prophylactic uses of monoclonal antibodies (mABs) against SARS-CoV-2 are limited by their short half-life and need for intravenous delivery. In this issue, Cobb et al.¹ engineer a neutralizing mAB cocktail with extended half-life that can be delivered intramuscularly to provide prophylactic protection against infection in rhesus macaques.

SUBMITTER: Izadpanah A

PROVIDER: S-EPMC8915435 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Engineering monoclonal antibodies for COVID-19 prophylaxis.

Izadpanah Amin A Rappaport Jay J

Med (New York, N.Y.) 20220301 3

The therapeutic and prophylactic uses of monoclonal antibodies (mABs) against SARS-CoV-2 are limited by their short half-life and need for intravenous delivery. In this issue, Cobb et al.<sup>1</sup> engineer a neutralizing mAB cocktail with extended half-life that can be delivered intramuscularly to provide prophylactic protection against infection in rhesus macaques. ...[more]

PMID: 35291730

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Project description:ImportanceThe COVID-19 pandemic has led to more than 900 000 deaths in the US and continues to disrupt lives even as effective vaccines are available.ObjectiveTo estimate the health outcomes and net cost of implementing postexposure prophylaxis (PEP) with monoclonal antibodies (mAbs) against household exposure to COVID-19.Design, setting, and participantsThis study is a decision analytical model of results from a randomized clinical trial of casirivimab with imdevimab administered as subcutaneous injections to unvaccinated, SARS-CoV-2-negative household contacts of people with confirmed COVID-19 with complementary data on household demographic structure, vaccine coverage, and confirmed COVID-19 case counts. The study used US data from May 2021 for a simulated population of US individuals of all ages within low-transmission or high-transmission scenarios.ExposuresAge, sex, race, ethnicity, and COVID-19 vaccination status.Main outcome or measuresSymptomatic infection, hospitalization, death, and net payer cost of monoclonal antibody PEP for COVID-19.ResultsIn a month of transmission intensity similar to that of May 2021, a mAb PEP program reaching 50% of exposed, unvaccinated household members aged 50 years and older was estimated to avert 1820 symptomatic infections (95% uncertainty interval [UI], 1220-2454 symptomatic infections), 528 hospitalizations (95% UI, 354-724 hospitalizations), and 84 deaths (95% UI, 55-116 deaths) in a low-transmission scenario and 4834 symptomatic infections (95% UI, 3375-6257 symptomatic infections), 1404 hospitalizations (95% UI, 974-1827 hospitalizations), and 223 deaths (95% UI, 152-299 deaths) in a high-transmission scenario. Without mAb PEP, the estimated cost of hospitalizations due to COVID-19 infections from household exposure in the lower transmission scenario was $149 million (95% UI, $115-$196 million), whereas the estimated hospitalization cost in the higher transmission scenario was $400 million (95% UI, $312-$508 million). In the lower transmission scenario, mAb PEP administered to 50% of eligible contacts aged 80 years and older was estimated to have 82% probability of saving costs, but was not associated with cost savings at age thresholds of 50 years and older or 20 years and older. In contrast, in the high-transmission scenario, mAb PEP administered to 50% of eligible household contacts had estimated cost savings in 100% of simulations at the 80-year age threshold, 96% of simulations at the 50-year threshold, and 2% of simulations at the 20-year thresholds.Conclusions and relevanceIn this modeling study of a simulated US population, a mAb PEP for COVID-19 program was estimated to improve health outcomes and reduce costs. In the setting of a susceptible variant of SARS-CoV-2, health system and public health actors would have an opportunity to improve health and reduce net payer costs through COVID-19 PEP with mAbs.

Dataset Information

Engineering monoclonal antibodies for COVID-19 prophylaxis.

Publications

Engineering monoclonal antibodies for COVID-19 prophylaxis.

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