BREAKTHROUGH ACUTE COVID-19 INFECTION DURING THE US OMICRON SURGE FOLLOWING ADMINISTRATION OF TIXAGEVIMAB/CILGAVIMAB IN IMMUNOCOMPROMISED PATIENTS WITH RHEUMATOLOGIC DISORDERS
Abstract: L08
Authors: Podgorski C et al.
Key content:
Protection with Tixagevimab/Cilgavimab (Evusheld®) from breakthrough COVID-19 infection in immunosuppressed patients with rheumatic disorders, especially in high risk patients under treatment with rituximab, is recommended but not well-established. This study aimed to the risk of breakthrough infection despite prophylaxis in these patients with Tixagevimab/Cilgavimab (Evusheld®). 157 fully vaccinated rheumatic patients received Tixagevimab/Cilgavimab. No serious adverse events occurred. There were 24 cases (15.3%) of breakthrough acute COVID-19 infection following Tixagevimab/Cilgavimab administration after an average of 99.5 days (ranging from 5-195 days) between the last dose and the date of breakthrough infection. Of these 24 Patients with different inflammatory rheumatic diseases (RA, SLE, ANCA Vasculitis, Poly/Dermatomyositis etc.) and breakthrough infections, 70% were under treatment with rituximab. The rest had different immunosuppressive medications. Most of the patients had mild to moderate symptoms and only two required hospitalisations.
Relevance:
In high risk patients with inflammatory rheumatic disease under immunosuppressive medication 6 monthly prophylaxis with Tixagevimab/Cilgavimab (Evusheld®) does not protect completely from breakthrough COVID-19 infection, but seems to prevent severe disease.
In my opinion this prophylaxis is especially recommended for patients under treatment with rituximab who developed no antibody response to SARS-CoV2 vaccination.
