Tixagevimab-cilgavimab for preventing breakthrough COVID-19 in dialysis patients: a prospective study
Issued Date
2024-11-01
Resource Type
ISSN
20488505
eISSN
20488513
Scopus ID
2-s2.0-85209642953
Journal Title
Clinical Kidney Journal
Volume
17
Issue
11
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Kidney Journal Vol.17 No.11 (2024)
Suggested Citation
Boongird S., Srithongkul T., Sethakarun S., Bruminhent J., Kiertiburanakul S., Nongnuch A., Kitiyakara C., Sritippayawan S. Tixagevimab-cilgavimab for preventing breakthrough COVID-19 in dialysis patients: a prospective study. Clinical Kidney Journal Vol.17 No.11 (2024). doi:10.1093/ckj/sfae309 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102180
Title
Tixagevimab-cilgavimab for preventing breakthrough COVID-19 in dialysis patients: a prospective study
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The effectiveness of tixagevimab-cilgavimab as pre-exposure prophylaxis (PrEP) against breakthrough coronavirus disease 2019 (COVID-19) in dialysis patients remains uncertain due to limited data. Methods: In this multicenter prospective study, we enrolled vaccinated dialysis patients and divided them into two groups: a tixagevimab-cilgavimab group (received a 150 mg/150 mg intramuscular dose of tixagevimab-cilgavimab) and a control group (age-matched patients not receiving tixagevimab-cilgavimab). The primary outcome was the breakthrough COVID-19 rate at 6 months, whereas secondary outcomes included COVID-19-related hospitalization, intensive care unit admission, endotracheal intubation and mortality. The safety of tixagevimab-cilgavimab was assessed. Results: Two hundred participants were enrolled, with equal numbers in each group (n = 100 each). Baseline characteristics were comparable between groups, except for a higher number of COVID-19 vaccine doses in the tixagevimab-cilgavimab group [median (IQR) 4 (3-5) vs. 3 (3-4); P =. 01]. At 6 months, the breakthrough COVID-19 rates were comparable between the tixagevimab-cilgavimab (17%) and control (15%) groups (P =. 66). However, the median (IQR) time to diagnosis of breakthrough infections tended to be longer in the tixagevimab-cilgavimab group [4.49 (2.81-4.98) vs 1.96 (1.65-2.91) months; P =. 08]. Tixagevimab-cilgavimab significantly reduced COVID-19-related hospitalization rates (5.9% vs 40.0%; P =. 02) among participants with breakthrough infections. All tixagevimab-cilgavimab-related adverse events were mild. Conclusion: The use of tixagevimab-cilgavimab as PrEP in vaccinated dialysis patients during the Omicron surge did not prevent breakthrough infections but significantly reduced COVID-19-related hospitalizations. Further research should prioritize alternative strategies.