{"doi":"10.1111/tid.14182","title":"Assessing the post hoc effectiveness of tixagevimab−cilgavimab for prevention of SARS‐CoV‐2 infections in solid organ transplant recipients","abstract":"BACKGROUND: Tixagevimab-cilgavimab (Tix-Cil) was authorized for prophylaxis against COVID-19 in immunocompromised patients from December 2021 through January 2023. Real-world effectiveness for solid organ transplant (SOT) recipients has been unclear. METHODS: We enrolled 911 SOT recipients into a longitudinal COVID-19 serology study, of whom 381 (42%) received ≥1 dose of Tix-Cil. We collected and analyzed data on incident SARS-CoV-2 infections and antibody kinetics for all patients from January 2022 to March 2023, including periods dominated by Omicron BA and BQ subvariants. RESULTS: Over 253 ± 131 days of follow-up, there were 324 new-onset SARS-CoV-2 infections: 117 (31%) in Tix-Cil treated and 207 (39%) in Tix-Cil untreated patients (p = .012). In analyses adjusting for demographic, clinical, and COVID-19 exposure factors, any Tix-Cil treatment was associated with lower infection risk (OR 0.52, 95% CI 0.27-0.96, p = .039) throughout the surveillance period including when more resistant BQ.1 and BQ.1.1 subvariants had emerged (12/1/2022 onwards). Among treated patients, receiving a Tix-Cil dose was associated with substantial and sustained increase in anti-spike IgG antibody and angiotensin-converting enzyme 2 binding inhibition levels (Abbott Architect assay) that together also demonstrated association with lower infection risk (p = .042). During the full surveillance period, the frequency of infections requiring hospitalization was low overall (N = 26, 2.9% of the total cohort) and not significantly different between Tix-Cil recipients (N = 12, 3.2% of treated patients) and non-Tix-Cil recipients (N = 14, 2.6% of untreated patients) with unadjusted p = .31 for between-group difference. CONCLUSION: In a large cohort of SOT recipients, we found that Tix-Cil reduced infection risk even amidst emergent Omicron subvariants. Additionally, the extent of measurable humoral response to Tix-Cil may indicate relative effectiveness. Pre-exposure monoclonal antibody therapy may represent a strategy that will continue to offer clinical benefit for immunocompromised persons who are known to derive limited protection from vaccinations.","journal":"Transplant Infectious Disease","year":2023,"id":363055,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9565,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":644746,"name":"Sandy Joung","orcid":"0000-0002-7582-3218","position":1,"is_corresponding":false},{"id":1117063,"name":"Minhao Wang","orcid":"0000-0003-0160-0254","position":2,"is_corresponding":false},{"id":754284,"name":"Teresa Tran","orcid":null,"position":3,"is_corresponding":false},{"id":1108339,"name":"Michelle Bravo","orcid":"0009-0003-8512-7587","position":4,"is_corresponding":false},{"id":1108703,"name":"Hibah Masoom","orcid":null,"position":5,"is_corresponding":false},{"id":1117064,"name":"Christine Chang","orcid":"0000-0003-0179-7800","position":6,"is_corresponding":false},{"id":1117065,"name":"Marilyn Mendez","orcid":"0000-0003-4224-9464","position":7,"is_corresponding":false},{"id":257446,"name":"Nancy Sun","orcid":"0000-0002-5283-8556","position":8,"is_corresponding":false},{"id":420103,"name":"J. Patel","orcid":"0000-0003-0618-6750","position":9,"is_corresponding":false},{"id":88921,"name":"M. Kittleson","orcid":"0000-0003-4492-2691","position":10,"is_corresponding":false},{"id":615441,"name":"Edwin C. Frias","orcid":"0000-0002-7058-2240","position":11,"is_corresponding":false},{"id":252823,"name":"John C. Prostko","orcid":null,"position":12,"is_corresponding":false},{"id":218312,"name":"Joseph E. Ebinger","orcid":"0000-0002-0587-1572","position":13,"is_corresponding":false},{"id":270108,"name":"Susan Cheng","orcid":"0000-0002-4977-036X","position":14,"is_corresponding":false},{"id":257448,"name":"Kimia Sobhani","orcid":"0000-0002-9297-3445","position":15,"is_corresponding":false},{"id":672029,"name":"Stanley C. Jordan","orcid":"0000-0002-0456-8635","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-19T01:14:28.054440Z","pmid":"37885435","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}