The following is a summary of “Real-World Experience of Tixagevimab and Cilgavimab (Evusheld) in Rheumatologic Patients on Rituximab,” published in the March 2023 issue of Rheumatology by Ocon, et al.

This study aimed to evaluate the effectiveness and safety of tixagevimab and cilgavimab (Evusheld) as pre-exposure prophylaxis in preventing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in rheumatologic patients on B-cell depleting agent rituximab therapy.

Rheumatologic patients on rituximab therapy may have a suboptimal response to vaccination against SARS-CoV-2, which poses a challenge in preventing severe infection. Therefore, Tixagevimab and cilgavimab have been authorized by the Food and Drug Administration for emergency use as pre-exposure prophylaxis.

A longitudinal cohort study followed rheumatologic patients on rituximab therapy who received Evusheld. Adverse events were monitored. The study included 43 patients with rheumatologic diagnoses, such as rheumatoid arthritis, ANCA vasculitis, immune-mediated myositis, Sjögren disease, and systemic lupus erythematosus. The average follow-up time was 100 ± 33 days.

One patient experienced symptomatic SARS-CoV-2 infection, confirmed by a home antigen test twice. The remaining 97.8% of patients did not contract acute SARS-CoV-2 infection during the follow-up period. The local cumulative SARS-CoV-2 incidence rate was 4.32%, with 32,074 new local cases reported simultaneously. Adverse events reported included myalgia, flu-like symptoms, fevers, injection site pain, and headache. No serious adverse events, anaphylaxis, or cardiac events occurred.

Evusheld effectively prevented symptomatic SARS-CoV-2 infection in rheumatologic patients on rituximab therapy. The administration of Evusheld could be part of a multilayered approach to risk mitigation in this high-risk population as pre-exposure prophylaxis. The study suggested that Evusheld could be a safe and effective option for preventing SARS-CoV-2 infection in the patient population.

Reference: journals.lww.com/jclinrheum/Abstract/2023/03000/Real_World_Experience_of_Tixagevimab_and.9.aspx