Evidence map›Paper›PMID 38183123›Full record

SynthesisEuropean journal of medical research2024

The efficacy of tixagevimab/cilgavimab (Evusheld) in prophylaxis and treatment of COVID-19 in immunocompromised patients: a systematic review and meta-analysis.

Shaymaa Glhoom, Aya Fergany, Dina El-Araby, Asmaa A Abdelkhalek, Asmaa Gomaa, Eman O Zayed, Mohamed Abd-ElGwad

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in European journal of medical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Shaymaa GlhoomFaculty of Pharmacy, Tanta University, Tanta, Egypt. phshimaamagdy@gmail.com.
Aya FerganyMicrobiology and Immunology Department, Faculty of Pharmacy, New Valley University, EL-Kharja, Egypt.
Dina El-ArabyMedical Agency for Research and Statistics, Giza, Egypt.
Asmaa A AbdelkhalekFaculty of Pharmacy, MSA University, Giza, Egypt.
Asmaa GomaaZoology Department, Faculty of Science, Al Azhar University, Cairo, Egypt.
Eman O ZayedFaculty of Pharmacy, Cairo University, Cairo, Egypt.
Mohamed Abd-ElGwadFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Al-Azhar University · EGCairo University · EGFayoum University · EGOctober University of Modern Sciences and Arts · EGSouth Valley University · EGTanta University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring the COVID-19 pandemic, some populations, including immunocompromised patients, could not tolerate COVID-19 vaccination or had low responses. Evusheld is a combined neutralizing monoclonal antibody containing tixagevimab and cilgavimab. The World Health Organization (WHO) has approved this combination as pre-exposure prophylaxis (PrEP) and treatment for immunocompromised patients. With the new variant, the (WHO) recommended an increase in dose from 300 to 600 mg with a booster dose after 6 months. The target of this review was to compare the efficacy of the two doses, 300 mg and 600 mg of tixagevimab/cilgavimab (Evusheld) as prophylaxis for higher-risk individuals to reveal if there is a significant difference in efficacy between those two doses of the drug.

methodsIn this study, electronic databases (PubMed, Web of Science core collection, Scopus, and Cochran) were investigated for articles up to 31/12/2022 in English using a well-established search strategy. We included studies conducted in immunocompromised patients (aged ≥ 12 years) (WHO) received Evusheld as prophylaxis or treatment for COVID-19. After excluding studies inconsistent with the selection criteria, 24 were involved, 22 of which were included in the meta-analysis. We analyzed the data by using RevMan 5.4 program software.

resultsIn the double-arm subgroup analysis, Evusheld 600 mg, administered as prophylaxis, showed no significant difference in the COVID-19 infection rate, mortality rate, or needed hospitalization rate compared with the dose of 300 mg (p = 0.13, p = 0.29, and p = 0.25, respectively). In the single-arm subgroup analysis, Evusheld 600 mg, administered as prophylaxis, showed a significant decrease in the COVID-19 infection rate and the hospitalization rate compared with the dose of 300 mg (p = 0.0001, p = 0.007, respectively). As a treatment, Evusheld showed a significant decrease in the mortality rate over the placebo group (p = 0.01) in COVID-19 patients.

conclusionThis result indicated that Evusheld was an effective prophylactic and therapeutic drug for COVID-19 infection, especially for immunocompromised patients, but there was no considerable variation between the high and low doses. Further prospective and randomized controlled trials (RCTs) with increased population sizes are necessary to show the valuable benefit of the high dose of Evusheld in COVID-19 prevention and treatment and to compare the difference between the two doses within adverse events.

Indexed as

Antibodies, MonoclonalAntibodies, NeutralizingCOVID-19COVID-19 Drug TreatmentDrug CombinationsImmunocompromised HostHumansAntibodies, MonoclonalAntibodies, Neutralizingcilgavimab and tixagevimab drug combinationDrug CombinationsAZD7442CilgavimabCOVID-19EvusheldTixagevimab

Identifiers

PMID38183123
PMCPMC10768288
OpenAlexW4390613593

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.