SARS-CoV-2 Neutralizing Monoclonal Antibodies for the Treatment of COVID-19 in Kidney Transplant Recipients.

Autor:	Wang AX; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California., Busque S; Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California., Kuo J; Pharmacy Manager of Clinical Effectiveness, Department of Pharmacy, Stanford Health Care, Stanford, California., Singh U; Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.; Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California., Röeltgen K; Department of Pathology, Stanford University School of Medicine, Stanford, California., Pinsky BA; Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.; Department of Pathology, Stanford University School of Medicine, Stanford, California., Chertow GM; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California.; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California., Scandling JD; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California., Lenihan CR; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Jazyk:	angličtina
Zdroj:	Kidney360 [Kidney360] 2021 Oct 20; Vol. 3 (1), pp. 133-143. Date of Electronic Publication: 2021 Oct 20 (Print Publication: 2022).
DOI:	10.34067/KID.0005732021
Abstrakt:	Background: Morbidity and mortality associated with coronavirus disease 2019 (COVID-19) infection in kidney transplant recipients are high and early outpatient interventions to prevent progression to severe disease are needed. SARS-CoV-2 neutralizing mAbs, including bamlanivimab and casirivimab-imdevimab, received emergency use authorization in the United States in November 2020 for treatment of mild to moderate COVID-19 disease. Methods: We performed a retrospective analysis of 27 kidney transplant recipients diagnosed with COVID-19 between July 2020 and February 2021 who were treated with bamlanivimab or casirivimab-imdevimab and immunosuppression reduction. We additionally identified 13 kidney transplant recipients with COVID-19 who had mild to moderate disease at presentation, who did not receive mAbs, and had SARS-CoV-2 serology testing available. Results: There were no deaths or graft failures in either group. Both infusions were well tolerated. Four of the 27 patients treated with mAbs required hospitalization due to COVID-19. Four of 13 patients who did not receive mAbs required hospitalization due to COVID-19. Patients who received mAbs demonstrated measurable anti-SARS-CoV-2 IgG with angiotensin-converting enzyme 2 (ACE2) receptor blocking activity at the highest level detectable at 90 days postinfusion, whereas ACE2 blocking activity acquired from natural immunity in the mAb-untreated group was weak. Conclusions: Bamlanivimab and casirivimab-imdevimab combined with immunosuppression reduction were well tolerated and associated with favorable clinical outcomes in kidney transplant recipients diagnosed with mild to moderate COVID-19. Competing Interests: A.X. Wang reports receiving research funding from CareDx. S. Busque reports receiving honoraria from Genentech; having consultancy agreements with, and serving as a scientific advisor for, or member of, Genentech and Gigagen; and having ownership interest in Gigagen. G.M. Chertow reports having consultancy agreements with Akebia, Amgen, Ardelyx, AstraZeneca, Baxter, Cricket, DiaMedica, Gilead, Miromatrix, Reata, Sanifit, Unicycive, and Vertex; serving on data safety monitoring boards for Angion, Bayer, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and ReCor; having ownership interest in Ardelyx, CloudCath, Durect, DxNow, Eliaz Therapeutics, Outset, Physiowave, and PuraCath; serving as coeditor of Brenner & Rector’s The Kidney (Elsevier) and on the board of directors for Satellite Healthcare; and receiving research funding from the NIDDK and National Institute of Allergy and Infectious Diseases (NIAID). C.R. Lenihan reports receiving research funding from Astellas and CareDx, and honoraria from Veloxis. J.D. Scandling reports serving as a scientific advisor for, or member of, AlloVir; receiving research funding and honoraria from CareDx; and having consultancy agreements with Horizon Pharma. U. Singh reports serving as a scientific advisor for, or member of, Gilead; and receiving honoraria from Gilead and Regeneron. All remaining authors have nothing to disclose. (Copyright © 2022 by the American Society of Nephrology.)
Databáze:	MEDLINE
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