Unveiling Protection: A Meta-Analysis of Tixagevimab-Cilgavimab
Prophylaxis in 28,950 Transplant Recipients and Immunocompromised
Patients Against COVID-19
Abstract
Background This meta-analysis addresses the efficacy and safety
of tixagevimab-cilgavimab as pre-exposure prophylaxis against COVID-19
in immunocompromised patients, particularly during the Omicron variant
surge. Given the limited vaccine response in this population,
alternative prophylactic strategies are critical. Methods
Following PRISMA guidelines, we comprehensively searched electronic
databases, including PubMed, Scopus, Web of Science, and Embase, up to
June 22, 2024. We included studies assessing tixagevimab-cilgavimab’s
impact on SARS-CoV-2 infection rates, hospitalization, ICU admissions,
and/or mortality among immunocompromised patients. Data synthesis and
analysis were conducted using RevMan and Open-Meta Analyst software.
Results Analyzing data from 36 studies involving 28,950
patients, tixagevimab-cilgavimab significantly reduced SARS-CoV-2
infection rates by 4.37%, hospitalization by 0.8%, and mortality by
0.5%. Compared to no prophylaxis, the drug combination showed a notable
reduction in SARS-CoV-2 infection (OR = 0.33, 95% CI: 0.22-0.50),
hospitalization (OR = 0.24, 95% CI: 0.15-0.39), and mortality (OR =
0.33, 95% CI: 0.16-0.66), exhibiting a favorable safety and efficacy
profile. During the Omicron surge, tixagevimab-cilgavimab consistently
reduced infection risk (OR = 0.32, 95% CI: 0.17-0.58).
Conclusion Tixagevimab-cilgavimab offers a significant
protective effect against COVID-19, including Omicron variants, in
immunocompromised patients, underscoring its role as an effective
pre-exposure prophylaxis. Future studies should further explore its
efficacy across different SARS-CoV-2 variants and potential synergies
with vaccination efforts.