Antibodies and Evusheld

The high dose chemotherapy has possibly wiped out all of the wife’s immunity to things like measles and SARS-CoV-2. At our last visit to hospital, they did an immunoassay for coronavirus antibodies, and we will probably get the results next week. Dependent on the level she may get Evusheld prophylaxis in the first instance. I should have some antibodies after three vaccinations and a dose of Covid. My chest is still a bit iffy after three courses of antibiotics. I probably qualify for a fourth vaccination, now.

This piece of information, from the immunoassay, will enable us to decide if we want to / can travel back to the UK to have a feel of how it now is. Having seen the shenanigans in the news and the ridiculous petty “leadership” contest, we are not at first pass attracted. I have no idea about how I will feel amidst all that congestion and claustrophobia. Seeing the images of the Brighton Sardine Resort beach today is not a tempting thing. All those pink sardines will have to get out of Brighton in the traffic jam, later today.

We are starting to factor in end of life thinking. Where would be a better place to dis-incarnate?

I have to think, a little, about life after too.

There are a number of pretty big decisions in the pipeline.

We can afford something within a thirty minute drive of CHU Brest and similarly 30 mins from Cardiff University Hospital. Around Rennes looks a bit pricey.

This radial travel time is perhaps a key criterion, upcoming.

Hmnn…

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Excerpted from Astra Zeneca Web Site

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PUBLISHED 24 March 2022

24 March 2022 18:00 GMT

(Updated 29 March 2022)

Recommendation based on Phase III PROVENT trial showing a significant reduction in the risk of developing symptomatic COVID-19, with protection lasting at least six months

 AstraZeneca’s Evusheld (tixagevimab co-packaged with cilgavimab), a long-acting antibody combination, has been recommended for marketing authorisation in the European Union (EU) for the pre-exposure prophylaxis (prevention) of COVID-19 in a broad population of adults and adolescents aged 12 years and older weighing at least 40 kg.

People not adequately protected by a COVID-19 vaccine may particularly benefit from pre-exposure prophylaxis with Evusheld. This includes about three million people in the EU who are immunocompromised or being treated with immunosuppressive medicines.

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency based its positive opinion on a review of Evusheld data, including results from the PROVENT Phase III pre-exposure prophylaxis trial, which showed a 77% reduction in the risk of developing symptomatic COVID-19 compared to placebo at the primary analysis and an 83% reduction at a six month median analysis, with protection from the virus continuing for at least six months. Evusheld was generally well-tolerated in the trial.

Hugh Montgomery, Professor of Intensive Care Medicine at University College London, UK and Evusheld investigator said: “Despite the success of vaccinations, we still need additional measures to prevent the spread of COVID-19 infections in Europe, where the number of cases of the highly transmissible BA.2 subvariant is rapidly increasing and where public health safety measures have been relaxed in many countries. This broad recommendation for Evusheld will allow health authorities in the EU to identify priority, high-risk populations needing additional protection such as people with cancer, transplant patients, or anyone taking immunosuppressive medicines, as well as those at increased risk of exposure.”

Evusheld
Evusheld, formerly known as AZD7442, is a combination of two long-acting antibodies – tixagevimab (AZD8895) and cilgavimab (AZD1061) – derived from B-cells donated by convalescent patients after SARS-CoV-2 infection. Discovered by Vanderbilt University Medical Center and licensed to AstraZeneca in June 2020, the human monoclonal antibodies bind to distinct sites on the SARS-CoV-2 spike proteinand were optimised by AstraZeneca with half-life extension and reduction of Fc effector function. The half-life extension more than triples the durability of its action compared to conventional antibodies; data from the PROVENT Phase III trial show protection lasting at least six months. The reduced Fc effector function aims to minimise the risk of antibody-dependent enhancement of disease – a phenomenon in which virus-specific antibodies promote, rather than inhibit, infection and/or disease.

Evusheld received Emergency Use Authorisation (EUA) in the US in December 2021 for the pre-exposure prophylaxis (prevention) of COVID-19 in people with moderate to severe immune compromise due to a medical condition or immunosuppressive medications and who may not mount an adequate immune response to COVID-19 vaccination, as well as those individuals for whom COVID-19 vaccination is not recommended due to a history of severe adverse reaction to a COVID-19 vaccine. Evusheld is also authorised for use and being supplied in several other countries around the world.

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