SARS-CoV-2-neutralising monoclonal antibodies to prevent COVID-19
Citation: Hirsch C, Park YS, Piechotta V, et al. SARS-CoV-2-neutralising monoclonal antibodies to prevent COVID-19. Cochrane Database of Systematic Reviews. 2022;6:CD014945.
Language: Abstract available in EN, ES, FA, FR, TH. Plain language summary available in EN, ES, FA, FR, HR, JA, MS, TH, ZH. Full text available in EN.
Free to view: Yes.
Funding sources: German Federal Ministry of Education and Research.
What is this? In this Cochrane review, the authors searched for randomised controlled trials that evaluated the effectiveness of SARS-CoV-2-neutralising mAbs in pre- and post-exposure prophylaxis for COVID-19. They searched in April 2022 for publications since January 2020. The authors included four trials (9749 participants) and identified four ongoing studies. Two additional studies awaited classification.
What works: For pre-exposure prophylaxis, tixagevimab/cilgavimab decreased the clinical symptoms of COVID-19, probably reduced the risk of infection with SARS-CoV-2, and possibly reduced hospital admissions. Casirivimab/imdevimab may also decrease infection with SARS-CoV-2 and the development of COVID-19 symptoms, however, it may increase rates of adverse events. For post-exposure prophylaxis, bamlanivimab decreased infection with SARS-CoV-2, but may increase rates of adverse events. Casirivimab/imdevimab decreased infection with SARS-CoV-2 and the development of clinical symptoms, but increasesd rates of adverse events.
What doesn’t work: Pre-exposure prophylaxis with tixagevimab/cilgavimab, bamlanivimab, or casirivimab/imdevimab resulted in little or no difference in mortality.
What is uncertain: The findings only apply to unvaccinated people and to the SARS-CoV-2 variants prevailing during the studies. It is unknown if the mAbs are effective against other variants, such as Omicron. The evidence for each comparison came from one study only. None of the studies reported quality of life.
Implications: The authors of the review concluded that further studies were needed to determine whether the mAbs are effective in vaccinated people and against other SARS-CoV-2 variants.
Other considerations: The authors of the review did not discuss their findings in the context of issues relating to health equity.
This summary was prepared by Catherine Haynes, checked by Grace Meng, and finalized by William Summerskill.