A somewhat limited, but real-world study in Japan, finds low Covid incidence in immunocompromised patients with hemotological disease having taken larger Evusheld prophylactic dose. This is during the Omicron wave.
Incidence of breakthrough COVID-19 in patients with hematological disorders who received pre-exposure prophylaxis with tixagevimab-cilgavimab: a retrospective study in Japan
" In conclusion, we performed a retrospective study to evaluate the incidence of COVID-19 in patients with hematological disorders after pre-exposure prophylaxis using Tix/Cil in Japan. Among the 257 patients analyzed, 18 developed COVID-19, but no patients died, suggesting the effectiveness of Tix/Cil for preventing the development of critical COVID-19. This is the first report describing the real-world experience during the Omicron era in Japan. Our results thus indicate that pre-exposure prophylaxis, vaccination, and early intervention for COVID-19 are effective strategies for decreasing the mortality risk in immunocompromised patients."
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JIDD
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Hi thank you for your post very reassuring. Unfortunately the U.K. government have refused to provide us with evusheld. Let’s hope research like this may change that decision.
I wouldn't take much encouragement from this, even if I could still get Evusheld. It's out of date and flawed.
The study is very flawed because:
1. No control arm - we don't know how much better or worse patients did than the general public or hematology patients without Evusheld
2. The 267 patients got Evuseld between October 2022 and January 2023, then got infected up to 93 days later - which could be as late as April, 2023 - multiple different variants
3. No sequencing was done (!?!) to determine infection variant. They say the most dominant strain was BA.5, which has responded poorly in in-vitro testing
4. Infected patients received Paxlovid and/or Remdesivir and/or were hospitalized (see Supplement). How much of their survival was due to antivirals, breathing care intervention, and how much due to Evusheld?
5. Current dominant variants are XBB family, which is a cross between BJ.1 (BA.2.10.1.1) and BM.1.1.1 (BA.2.75.3.1.1.1). Evusheld is unlikely to neutralize them - see reference below.
6. Hematology patients are more likely to mask and shun contact than the general population.
My own experience with Evusheld and COVID BA.2 in May 2022 was that I was antigen positive for 21 days and got a secondary staphylococcus infection that took over a month to clear. I was Watch and Wait, had had 4 shots of mRNA vaccines, and 300mg each of Tixagevimab and Cilgavimab. I got Paxlovid, and later, 3 different antibiotics for the secondary infection. I do think it kept me out of the hospital, but BA.2 was one of the last variants that responded to Evusheld. I depend on my own and my wife's continued masking, and I avoid crowded indoor spaces, and eat unmasked only outdoors. I am currently in treatment, with good Neutrophils, no CD-19 B-cells at all on the last flow cytometry, and IgG
I look forward to getting SuperNova when it is finally released. The SuperNova study will provide much better data, because it compares AZD3152 to Evusheld (AZD7442), with possible preliminary results by November, 2023.
What a shame that Evusheld is no longer available. As per CLLerinOZ AZ is working on a new and improved Evusheld. I hope and pray that they are successful.
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Clinical Trials of Monoclonal antibodies AZD7442 against SARS=CoV-2 (COVID19) - majority of sites in UK and USA
COVID-19 management strategies and vaccine recommendations for patients with hematologic malignancies, USA NY Presbyterian perspective
