The neutralizing monoclonal antibody combination of tixagevimab/cilgavimab has been shown to reduce the risk of SARS-CoV-2 infection in unvaccinated individuals during the Alpha (B.1.1.7) and Delta (B.1.617.2) waves. However, data on the efficacy and safety of tixagevimab/cilgavimab in vaccinated solid organ transplant recipients during the Omicron wave is limited. To address this, we conducted a retrospective cohort study comparing 222 solid organ transplant recipients (SOTRs) who received tixagevimab/cilgavimab for pre-exposure prophylaxis and 222 vaccine-matched solid organ transplant recipients who did not receive tixagevimab/cilgavimab. Breakthrough SARS-CoV-2 infections occurred in 11 (5%) of SOTRs who received tixagevimab/cilgavimab and in 32 (14%) of SOTRs in the control group (p < .001). In the tixagevimab/cilgavimab group, SOTRs who received the 150–150 mg dose had a higher incidence of breakthrough infections compared to those who received the 300–300 mg dose (p = .025). Adverse events were uncommon, occurring in 4% of our cohort and most were mild. There was no significant change in serum creatinine or liver chemistries in kidney and liver transplant recipients, respectively. In conclusion, we found that tixagevimab/cilgavimab use is safe and associated with a lower risk of breakthrough SARS-CoV-2 infection in vaccinated solid organ transplant recipients during the Omicron wave.

中文翻译：

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在 omicron 波期间，tixagevimab/cilgavimab 暴露前预防与接种疫苗的实体器官移植受者的突破性感染风险较低有关

tixagevimab/cilgavimab 的中和单克隆抗体组合已被证明可以降低未接种疫苗的个体在 Alpha (B.1.1.7) 和 Delta (B.1.617.2) 波期间感染 SARS-CoV-2 的风险。然而，关于 tixagevimab/cilgavimab 在 Omicron 浪潮期间接种疫苗的实体器官移植受者的有效性和安全性的数据是有限的。为了解决这个问题，我们进行了一项回顾性队列研究，比较了 222 名接受 tixagevimab/cilgavimab 进行暴露前预防的实体器官移植受者 (SOTR) 和 222 名未接受 tixagevimab/cilgavimab 的疫苗匹配实体器官移植受者。SARS-CoV-2 突破性感染发生在接受 tixagevimab/cilgavimab 的 11 名 (5%) SOTR 和对照组的 32 名 (14%) SOTR 中（p <.001）。在 tixagevimab/cilgavimab 组中，接受 150-150 mg 剂量的 SOTR 与接受 300-300 mg 剂量的 SOTR 相比，突破性感染的发生率更高 ( p  = .025)。不良事件并不常见，发生在我们队列中的 4%，而且大多数是轻微的。肾脏和肝脏移植受者的血清肌酐或肝脏化学分别没有显着变化。总之，我们发现使用 tixagevimab/cilgavimab 是安全的，并且与在 Omicron 浪潮期间接种疫苗的实体器官移植受者发生突破性 SARS-CoV-2 感染的风险较低有关。