Impact of Bebtelovimab Treatment Timing on COVID-19 Outcomes in Ambulatory Solid Organ Transplant Recipients.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2024-11-16 DOI:10.1111/tid.14405

Sonsoles Salto-Alejandre, Willa Cochran, Zishan Siddiqui, Julie Langlee, Lauren Boyer, Kristin Freed, Sophia Purekal, Ishaan Gupta, Mary Grace Bowring, Daniel C Brennan, William Werbel, Robin K Avery

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引用次数: 0

Abstract

Background: Outcomes after bebtelovimab treatment for COVID-19 were favorable for most but not all solid organ transplant recipients (SOTRs) during the era of Omicron BA.2 to BA.5, but effects of timing of bebtelovimab administration on these outcomes are unknown. We sought to compare outcomes of SOTR who received early bebtelovimab ("EBT", given ≤ 2 days from diagnosis) versus late bebtelovimab ("LBT", given between Days 3 and 7), versus no bebtelovimab (NBT).

Methods: This was a retrospective cohort study of SOTRs with mild-to-moderate COVID-19, with endpoint of 30-day COVID-19-related hospitalization. Multivariable logistic regression was performed to determine variables associated with receiving EBT, and to assess impact of EBT on hospitalization. A propensity score (PS) was calculated for EBT versus NBT.

Results: Of 297 SOTRs, 162 (58.1%) received EBT, 46 (16.5%) LBT, and 71 (25.4%) NBT. Early bebtelovimab treatment was associated with a lower risk of 30-day COVID-19-related hospitalization compared to NBT (OR, 0.112 [95% CI, 0.018-0.686]; p = 0.018). There was no significant difference in hospitalization risk between LBT and NBT, suggesting that delayed administration may not confer additional benefits over no treatment.

Conclusions: Early bebtelovimab treatment in outpatient SOTRs was associated with a lower risk of hospitalization compared to no treatment, while late administration did not show a significant advantage over no treatment. Although bebtelovimab is no longer authorized, these findings suggest that the timing of COVID therapies for SOTRs may be important to optimize outcomes.

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贝特罗单抗治疗时机对非卧床实体器官移植受者 COVID-19 结局的影响

背景：在Omicron BA.2至BA.5时代，大多数但并非所有实体器官移植受者（SOTR）在接受贝特罗单抗治疗COVID-19后疗效良好，但贝特罗单抗给药时间对这些疗效的影响尚不清楚。我们试图比较接受早期贝特罗单抗（"EBT"，在确诊后 2 天内给药）和晚期贝特罗单抗（"LBT"，在第 3 天和第 7 天之间给药）以及未接受贝特罗单抗（NBT）的器官移植受者的预后：这是一项针对轻度至中度 COVID-19 SOTR 的回顾性队列研究，研究终点为 30 天 COVID-19 相关住院治疗。通过多变量逻辑回归确定与接受 EBT 相关的变量，并评估 EBT 对住院治疗的影响。计算了 EBT 与 NBT 的倾向得分（PS）：在 297 例 SOTR 中，162 例（58.1%）接受了 EBT，46 例（16.5%）接受了 LBT，71 例（25.4%）接受了 NBT。与 NBT 相比，早期贝特罗单抗治疗与较低的 30 天 COVID-19 相关住院风险相关（OR，0.112 [95% CI，0.018-0.686]；P = 0.018）。LBT和NBT的住院风险无明显差异，这表明延迟给药可能不会比不给药带来更多益处：结论：与不治疗相比，SOTR门诊患者早期接受贝特罗单抗治疗可降低住院风险，而延迟用药与不治疗相比并无明显优势。尽管贝特罗单抗已不再获批上市，但这些研究结果表明，COVID疗法治疗SOTR的时机可能对优化疗效非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.