Hi everyone, I’m just asking for some advice. My husband finished 12 months of Obinutuzumab/Venetoclax in April and we’ve done our own research and discovered that he is eligible to receive Evusheld. (We're in Australia) When we approached our specialist, he firstly told us it was only available to bone marrow transplant recipients. When we later presented the evidence that my husband was indeed eligible, he told us that it has never been trialled on cancer patients, or omicron. The risks were a heart attack or stroke and that the government had only expanded the program to include other categories of patients because they’d spent a lot of money on it and it hadn’t been taken up and was fast running out of date. My question is, has anyone else got any information on Evusheld from their specialist or gone ahead and had the treatment?
Evusheld - Do the risks outweigh the benefits? - CLL Support
Evusheld - Do the risks outweigh the benefits?
It's a question worth asking The patient fact sheet issued by the FDA says of cardiac events " Serious cardiac adverse events have happened,
but were not common, in people who received EVUSHELD and also in
people who did not receive EVUSHELD in the clinical trial studying
pre-exposure prophylaxis for prevention of COVID-19. In people with risk
factors for cardiac events (including a history of heart attack), more people
who received EVUSHELD experienced serious cardiac events than people
who did not receive EVUSHELD. It is not known if these events are related
to EVUSHELD or underlying medical conditions". Bear in mind that the FDA has not approved Evusheld, only given it emergency use authorisation. The UK's MHRA has given Evusheld conditional approval and the government advice to patients makes no mention of cardiac issues among possible side effects gov.uk/government/publicati...
The leaflet produced by Australia's Therapeutic Goods Administration provides the same information about cardiac side effects that bennevisplace has given you.
healthdirect.gov.au/medicin...
The following link to a report about Evusheld's effectiveness against Omicron was recently added to the pinned post about SARS-CoV-2
( healthunlocked.com/cllsuppo... ):
medrxiv.org/content/10.1101...
The criteria for Evusheld was broadened, at least in my Australian state - Victoria, on 27 May 2022 to include:
heart/lung transplant recipients
STEM Cell Transplant or CAR T-cell therapy recipients within 12 months OR STEM Cell recipients with GVHD OR still requiring significant ongoing immunosuppression for other reasons
kidney, pancreas/islet cell or liver transplant recipients within 12 months OR requiring therapy for acute rejection OR still requiring significant ongoing suppression for other reasons
individuals with severe combined immunodeficiencies
Individuals who within the last 12 months received:
- anti-CD20 antibodies (rituximab, obinutuzumab, ocrelizumab, ofatumumab)
- BTK inhibitors (ibrutinib, acalabrutinib, zanubrutinib)
- BLC2 inhibitor (venetoclax)
- anti-CD38 (daratumumab)
- anti-BCMA bi-specific antibody
- sphingosine 1- phosphate receptor modulators (fingolimod, siponimod)
- anti-CD52 antibodies (alemtuzumab)
- anti-complement antibodies (eculizumab)
- anti-thymocyte globulin
- high dose (> 1 g/m²) cyclophosphamide.
In exceptional circumstances, access to Evusheld™ may be considered for patients who do not fit within the eligibility requirements. Refer to request to access form for further information.
I've just realised that you joined our community only today. Welcome to the site! You'll find a lot of great information and support here.
In my last reply to you, I referred to 'pinned posts'. If you're using a laptop or PC, the pinned posts will appear to the right of your browser screen. If you're using a phone, they'll appear at the bottom.
There are pinned posts on a range of topics but a good one to start with is:
healthunlocked.com/cllsuppo...
I suspect that very few CLL patients in Australia have received Evusheld (unless they have had CAR-T therapy) because the criteria didn't include them until recently, even though they were included in the original provisional approval statement. Just the same, you may find you receive more replies to your question if you lock your post so it can be seen by site members only. The pinned post above gives more information about locked and unlocked posts.
If you do wish to lock your post, click on 'More v' at the bottom of your original post, then click on 'edit'. Scroll to the bottom of the post and change the setting from everyone to Community Only.
By the way, when I asked about Evusheld less than two weeks ago, the hospital I am being treated at didn't have any except for certain transplant patients but that was before the criteria were expanded.
Thanks for the welcome and that info. I have changed my settings now to community only.From what I understand the only hospital with Evusheld is the Alfred and your specialist needs to access the forms on the health.vic.gov.au site
health.vic.gov.au/covid-19/...
It has the criteria for who is eligible and at the bottom of the page, the form for clinicians to fill in.
We have a form signed by our specialist ready to email, but after his negativity, I feel like it's a case of choose your poison, Covid or Evusheld
While the Alfred holds the central supply of Evusheld in Victoria, it does distribute it to other hospitals around the state so it can be administered to approved patients on a more local basis. 'Stock will be supplied by Alfred Pharmacy and organised by the local hospital pharmacy department for approved patients."
At present, it appears that the dosage in Victoria is not the same as that being used in the US. The information currently available in Victoria says:
'What is the current recommended dose of tixagevimab and cilgavimab (EvusheldTM)?
Currently, the dose recommendation is 150 mg of tixagevimab and 150 mg of cilgavimab administered as separate sequential IM injections. See the product information <tga.gov.au/sites/default/fi... for further information. It is noted that the U.S. Food and Drug Administration (FDA) has recommended a higher dose in the United States due to circulating Omicron subvariants BA.1 and BA.1.1. '
There's further discussion about Evusheld in this post which gives details about its effectiveness against different variants which may help your husband make his decision:
I asked the specialist today whether Evusheld was available yet and was told that the ACT hospital is still deciding on criteria for selection.
Hi Gretriever, I live in Canberra and am about 8 months into Obinutuzumab/Venetoclax treatment so with the latest criteria quoted by CLLerinOz definitely qualify for Evusheld. I have monthly check ups with my haematologist and have been querying her about Evusheld for the last 3 appointments.
To start with, apparently there was only a small amount of it in the country and then it was still being discussed about who should be eligible.
At my last checkup, last Thursday, I was told that Evusheld is now available, but in order to receive it I must first have a ‘blood test to check that my antibody measurement qualifies me’. I now await a phone call to invite me along for this antibody test.
I am very surprised and rather cross if because of all this procrastination we are letting stocks of Evusheld become out of date when there are so many people in Australia who would benefit from it. Also I am amazed that Australia is still dosing at 150mg of each rather than the 300mg recognised as being appropriate in the US.
In the meantime I will stay safely in my hermit kingdom!
Keep walking
Lilsa
Well on about cycle 9 of V&O my oncologist told me she ordered it for me and if you had chemo you were eligible. So far so good. I still talk back. Good luck.
I have been on ibrutinib for four years. I had Evusheld in March. Absolutely no side effects. My husband got Covid but I didn’t. I think it was well worth it.
My consultant believes it Evusheld isn't necessary for me , I have been in remission for 9 months after a stage 4 diagnosis in 2020. I have no other comorbidities, 58, had all my jabs and 3 covid infections, still no antibodies, hopefully 5 jab and another dose of Covid may do the trick.
You have no antibodies but your consultant doesn't think it's warranted? After getting multiple Covid infections to boot? I think that is odd. IDK any comorbidities/medications you may have/be taking, but I personally would insist on it unless there was a compelling reason not to have it.
I think it's the fact that the current variant is not a great concern, I have had alpha, Delta and Omicron, I was only hospitalised with Delta as a precaution and given antibodies, although my breathing was OK my Platelets had dropped due to covid and there were concerns about a PE. The other 2 were treated with Paracetamol.
Not an urgent concern for life threatening hospitalization, I would agree. Long Covid, I haven't seen any data and would be leery. For me, personally, with no cardiac disease or other major comorbidities. My anxiety and depression and fibromyalgia that flares when stressed probably aren't as critical to consider, compared to cardiac issues, or metabolic syndrome, or poorly controlled diabetes. I do think if one has any lung disease, that would indicate all the prevention one could get. And reducing my anxiety by getting it, IMO trumps any possible side effect lololol!
You didn't say what treatment you had, but if it included anti CD20 that might have contributed to all the Covid episodes, I would be concerned that another opportunistic or pathogenic pneumonia would take hold if you get yet another Covid infection. But everyone is different, their disease is different, and it's great our docs are making a decision based on *us*, not just blindly following some recommendation to treat or not!
I thought about Long covid , especially after 3 infections, but it's difficult to tell... CLL , acalabrutinib side effects, old age , running after my 4 and 2 Yr olds... all contributed to various aches and pains... be virtually impossible to link one to long covid.
IDK, but maybe a second opinion on whether Evusheld is warranted in your situation would be a good move.
Having had a 40 Yr career in pathology and immunology I think my consultant has it spot on.
A number of us in the San Francisco area sought out Evusheld and I know of no one who had a bad reaction. Fortunately we had a local infusion center in Oakland (Total Infusions) that only required any physician referal, while my CLL expert at Stanford University required that I show no antibody production. Thus I could not get it at Stanford. A couple of shots, no side effects AND it plumped up my platelets, which had been very low. A good choice for me.
My sister is a lymphoma patient at MSK and is undergoing treatment. She was given Evushield twice. Her doctor said she can now not be afraid of Covid.
I am in USA. on Calquence. My Onc Dr offered me Evusheld and had it administered in their infusion room at the clinic. I had no problems or side effects.
I am still on the Venetoclax portion of V&O and my CLL doc had me receive Evushield. I did not know of the potential risk (possibly good that I didn’t know!). I had it in March and so far I’m ok!
I got it. I am more concerned about possible effects from Covid, compared to possible effects from Evusheld. I don't have any cardiac disease, or other major system disease. I am under treatment, and probably have few antibodies of my own.
I completed my 12 month obinutuzumab/Venclexta treatment regimen March 1st. My cardiologist said that I needed to get an Evusheld shot. I told my oncologist, who said he totally agreed and scheduled me for my 2 Evusheld injections. The cancer center did the work and you must hang around for an hour after your injections. Evusheld is good for 6 months at which time I will return and get another two injections this late August/September. If I were you, I would look around for a different oncologist who is up-to-date on current medical protocols for CLL patients.
I am in the US and got evusheld on the recommendation of dana farber a few months ago. I had no reaction and no Covid. I’ve had 4 moderna shots.
I have waldenstrom blood cancer but no transplant. I’ve talked with or saw comments from people who got the evusheld injection and no adverse effects were reported.
In my inbox this morning from Cancer Therapy Advisor, small study:"Evusheld Appears Less Effective Against Omicron for Patients With Blood Cancer"
cancertherapyadvisor.com/ho...
That study had only 52 patients, and was using the original 150mg dose. I think it was one of the ones used to bump the recommended dose up to 300mg from the original 150mg. They gave an additional 150mg to a few patients, and their level of antibodies got closer to what is considered the current neutralizing number.
I had it with no side effects. My oncologist recommended it.
Hi. In the USA. Still in W/W. With the ok of CLL specialist, I had Evusheld (2 shots) 2 weeks ago. I had no adverse reaction...I am glad I decided to do it.
Death rates for those 65 and older rose substantially during this past winter's Omicron wave, as compared to the previous Delta wave. (New York Times May-31-22)
Or see
nytimes.com/2022/05/31/heal...
I have a good idea about what can happen to me should I get the current Omicron variant. I will take my chances with Evusheld.
Owen
I am inclined to agree with you. At this point in time, I'm of the opinion my husband should have Evusheld, but his hemotologist not supporting us in this decision is causing me to hesitate. As a result I have booked an appointment with a well respected CLL specialist to obtain a second opinion.
This is my first time posting, but I'm spurred to do so because the doctor advising against Evusheld really surprises me. My husband has CLL and he generated a low antibody response to the vaccine. His oncologist here in California recommended Evusheld and he got two shots at the same time (the recommended dose here in the US) and had no negative effects. Because he has a history of atrial fibrillation (due to ibrutinib, which they switched him off of and onto Brukinsa and the a-fib went away), we ran the question by a cardiologist and she said it was fine for him to get it. She said the cardiac warning was for people with a history of heart attack. Anyway, this is just our experience.
I have no faith in the response we got from our Haemotologist so we are seeking a second opinion. Only downside is our appointment isn't until the 28th June. Lets hope we don't come into contact with Covid while we wait.
i go to Duke health they highly recommend it if you are fortunate to find it available i had it. no side effects
Not what you're looking for?
You may also like...
Got Evusheld After 19 Phone Calls!
Evusheld and Paxlovid Issue
Evusheld in California
EVUSHELD
Evusheld and booster and IVIG
Evusheld in the UK
I wonder if anybody got Evusheld in the UK.
Fund Evusheld petition
Evusheld and heart
