Efficacy and safety of tixagevimab‐cilgavimab as pre‐exposure prophylaxis for COVID‐19: A systematic review and meta‐analysis

Abstract

AbstractSome proportions of populations, such as immunocompromised patients and organ transplant recipients might have inadequate immune responses to the vaccine for coronavirus disease 2019 (COVID‐19). For these groups of populations, administering monoclonal antibodies might offer some additional protection. This review sought to analyze the effectiveness and safety of tixagevimab‐cilgavimab (Evusheld) as pre‐exposure prophylaxis against COVID‐19. We used specific keywords to comprehensively search for potential studies on PubMed, Scopus, Europe PMC, and ClinicalTrials.gov sources until 3 September 2022. We collected all published articles that analyzed tixagevimab‐cilgavimab on the course of COVID‐19. Review Manager 5.4 was utilized for statistical analysis. Six studies were included. Our pooled analysis revealed that tixagevimab‐cilgavimab prophylaxis may decrease the rate of SARS‐CoV‐2 infection (OR: 0.24; 95% CI: 0.15–0.40, p < 0.00001, I2 = 75%), lower COVID‐19 hospitalization rate (OR: 0.13; 95% CI: 0.07–0.24, p < 0.00001, I2 = 0%), decrease the severity risk (OR: 0.13; 95% CI: 0.07–0.24, p < 0.00001, I2 = 0%), and lower COVID‐19 deaths (OR: 0.17; 95% CI: 0.03–0.99, p = 0.05, I2 = 72%). In the included studies, no major adverse events were reported. This study proposes that tixagevimab‐cilgavimab was effective and safe for preventing COVID‐19. Tixagevimab‐cilgavimab may be offered to those who cannot be vaccinated or have inadequate immune response from the COVID‐19 vaccine to give additional protection.