Bebtelovimab approved by FDA, reduces risk of hospitalisation with Omicron variant of Covid19

[bennevisplace]

Another monoclonal antibody for at-risk Covid patients has become available in the USA investor.lilly.com/news-rel...

According to Lilly, bebtelovimab "demonstrates neutralization against the Omicron variant". Further, "The authorized dose of bebtelovimab is 175 mg given as an intravenous injection over at least 30 seconds".

[Justasheet1]

Now try to find it 😪

[Justasheet1]

Benn,

I thought I was pretty special when I scored the Evusheld in January. Now I’m supposed to win the lottery again for another dose of it?

Now this antibody? Sheesh…

I’m resigned to getting Paxlovid when infected. It’s plentiful and as far as I know is still effective.

Jeff

[Jonquiljo in reply to Justasheet1]

Yes, the US has ordered 20 million courses of Paxlovid with delivery to be completed by August.

[clladytime in reply to Jonquiljo]

It contradicts with btk inhibitors such as Imbruvica so is not for everyone.

[Justasheet1 in reply to clladytime]

Ladytime,

You are correct about it not being used concurrently with ibrutinib.

Most CLL experts are recommending holding the ibrutinib for the 5 days that you would need to take the Paxlovid.

Jeff

[bennevisplace in reply to Justasheet1]

You could be right in putting your faith in Paxlovid. If BA.2 takes hold the monoclonals can't be relied on.

[Jonquiljo in reply to bennevisplace]

How effective is Bebtelovimab against BA.2? They must have educated guesses by now.

Antivirals will take the most "variance" by the nature of how they work. They target viral replication proteins, and do not work by simply binding to the surface spike protein.

All antibodies (produced by vaccines or added by monoclonal infusions) work by neutralizing virus by blocking it's spike protein which is not very conserved. For instance -- basic omicron has over 30 mutations in it's spike protein when compared with the original Wuhan strain.

[bennevisplace in reply to Jonquiljo]

Regardless of sotrovimab’s abilities, bebtelovimab could become a go-to antibody to prescribe for people infected with BA.2. Ho and his colleagues found that it is active against both BA.1 and BA.2. nature.com/articles/d41586-...

Worth mentioning that all neutralisation studies to date are in vitro. I have seen one reporting that AZD7442 (Evusheld) holds up against BA.2 and another reporting that it doesn't.

Not sure what in vitro studies would be useful to confirm efficacy of antivirals like Paxlovid against BA.2, but you're probably right that they would have broader activity than mAbs.

Also worth mentioning that BA.2 is not a big deal in most countries - yet - but locally e.g. Denmark it has made rapid progress nextstrain.org/groups/neher...