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. 2022 Oct 31:ciac855. doi: 10.1093/cid/ciac855

Effectiveness of Evusheld in Immunocompromised Patients: Propensity Score-Matched Analysis

Ronza Najjar-Debbiny 1,2,, Naomi Gronich 3,4, Gabriel Weber 5,6, Nili Stein 7,8, Walid Saliba 9,10,11
PMCID: PMC9623900  PMID: 36310534

Abstract

Background

Tixagevimab and Cilgavimab, a combined monoclonal antibody (Evusheld) was granted emergency use authorization for SARS-CoV-2 preexposure prophylaxis in individuals with moderate to severe immunocompromising condition. In this study we used population-based real-world data to evaluate the effectiveness of Evusheld in immunocompromised patients.

Methods

Using the computerized database of the largest healthcare provider in Israel, we identified all adult immunocompromised patients who were eligible to receive Evusheld (the dose used during the study period was 150 mg Tixagevimab and 150 mg Cilgavimab) on 15-February-2022. Patients with a documentation of a prior SARS-CoV-2 infection were excluded. A total of 703 patients who received Evusheld were propensity score-matched, using a ratio of 1:4, with 2812 patients who have not received Evusheld (control group). Patients were followed through 30-June-2022 for up to 90-days for the first documentation of SARS-CoV-2 infection and COVID-19 related hospitalization.

Results

Overall, 72 patients in the Evusheld group and 377 patients in the control group had SARS-CoV-2 infection, reflecting and incidence rate of 4.18 and 5.64 per 100 person-months, respectively. HR was 0.75(95%CI,0.58-0.96) for SARS-CoV-2 infection, and 0.41(0.19-0.89) for COVID-19 related hospitalization in the Evusheld group compared to the control group. The magnitude of relative risks reduction of each outcome was greater in non-obese patients (P for interaction = 0.020 and 0.045, respectively).

Conclusion

This study suggests that Evusheld (150 mg Tixagevimab and 150 mg Cilgavimab) is effective in reducing the risk of SARS-CoV-2 infection and COVID-19 hospitalization in immunocompromised patients. The effectiveness of this dose appears to be greater in non-obese patients

Keywords: COVID-19, effectiveness, Evusheld, SARS-CoV-2, Tixagevimab and Cilgavimab


We assessed the real-world effectiveness of Evusheld in immunocompromised patients. The study shows that Evusheld is associated with reduced risk of SARS-CoV-2 infection and COVID-19 related hospitalization. The magnitude of the effectiveness appears to be greater in non-obese patients.

Contributor Information

Ronza Najjar-Debbiny, Infection Control and Prevention Unit, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Naomi Gronich, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel.

Gabriel Weber, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Infectious Diseases unit, Lady Davis Carmel Medical Center, Haifa, Israel.

Nili Stein, Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel; Statistical Unit, Lady Davis Carmel Medical Center, Haifa, Israel.

Walid Saliba, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel; Translational Epidemiology Unit and Research Authority, Lady Davis Carmel Medical Center, Haifa, Israel.

Supplementary Material

ciac855_Supplementary_Data

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

ciac855_Supplementary_Data

Articles from Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America are provided here courtesy of Oxford University Press

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