Publication date: Aug 08, 2024
The COVID-19 pandemic saw the largest deployment of monoclonal antibodies (mAbs) for an infectious disease in history. mAbs to SARS-CoV-2 spike protein proved safe and were initially effective for COVID-19 therapy, but each was defeated by continued SARS-CoV-2 evolution, leading to their withdrawal. This was a setback for people with impaired immunity who cannot mount an effective antibody response to SARS-CoV-2 and often cannot clear the virus. New mAbs have now been developed for pre-exposure prophylaxis (PreEP) in immunosuppressed people. Here we argue that while mAb use for PreEP is justified, single mAbs should not be used for COVID-19 therapy. In contrast to PreEP where the viral inoculum is small, immunosuppressed people with COVID-19 have large viral burden that can harbor mAb-escape variants that single-agent mAb treatments can rapidly select for resistance. Selection of mAb-escape variants has potential risks for patients, society and the feasibility of mAb therapy itself.
Concepts | Keywords |
---|---|
Antibodies | Antibodies |
Covid | Cov |
Pandemic | Covid |
Safe | Effective |
Therapy | Escape |
Immunosuppressed | |
Mab | |
Mabs | |
Monoclonal | |
Preep | |
Sars | |
Single | |
Therapy | |
Variants | |
Viral |
Semantics
Type | Source | Name |
---|---|---|
disease | MESH | COVID-19 |
disease | MESH | infectious disease |
pathway | REACTOME | Infectious disease |
disease | IDO | history |
disease | VO | effective |