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IDSA Suggests New Preventive COVID-19 Agent

Latest guidelines suggest use of pre-exposure prophylaxis in immunocompromised patients


The Infectious Diseases Society of America has released guidelines suggesting the use of pemivibart to prevent severe COVID-19 in immunocompromised patients. People who are immunocompromised are at greater risk of hospitalization, mechanical ventilation or death because of COVID-19.

The guideline panel suggests that pemivibart be administered to patients aged 12 and older who are moderately to severely immunocompromised when dominant COVID-19 variants in the patient’s region are susceptible to the agent. Evidence suggests pemivibart protects against severe COVID-19 caused by Omicron subvariants. Changes in susceptibility due to the emergence of new variants may influence the effectiveness of pemivibart, and the panel is closely monitoring these developments.

“Health care professionals need every tool available to protect their most vulnerable patients from the very real risks COVID-19 continues to pose,” said Adarsh Bhimraj, MD, FIDSA, director of Infectious Diseases Education & Fellowship at Houston Methodist Hospital and lead author of the guideline. “IDSA’s guideline update will help clinicians make the right decisions for their patients’ health and well-being.”

The U.S. Food and Drug Administration granted emergency use authorization for pemivibart in March for individuals who are moderately to severely immunocompromised. Pemivibart is currently the only FDA-approved pre-exposure prophylaxis for COVID-19. In January 2023, the FDA withdrew its EUA for tixagevimab/cilgavimab (Evusheld), an early COVID-19 pre-exposure prophylaxis antibody, because of limited efficacy against dominant COVID-19 variants. 

Higher- and moderate-risk patients who may benefit from pemivibart pre-exposure prophylaxis include those with recent hematopoietic stem cell or organ transplants, those undergoing cancer treatment and people living with advanced HIV infection, according to the guidelines. 

In addition to Dr. Bhimraj, guideline authors include Yngve Falck-Ytter, MD; Arthur Y. Kim, MD, FIDSA; Jonathan Z. Li, MD, FIDSA; Lindsey R. Baden, MD, FIDSA; Steven Johnson, MD, FIDSA; Robert W. Shafer, MD; Shmuel Shoham, MD, FIDSA: Pablo Tebas, MD, FIDSA; Roger Bedimo, MD, MS, FIDSA; Vincent Chi-Chung Cheng, MD: Kara W. Chew, MD, MS; Kathleen Chiotos, MD; Eric S. Daar, MD; Amy L. Dzierba, PharmD; David V. Glidden, PhD; Erica J. Hardy, MD, MMSc; Greg S. Martin, MD, MSc; Christine MacBrayne, PharmD; Nandita Nadig, MD; Mari M. Nakamura, MD; Amy Hirsch Shumaker, PharmD; Phyllis Tien, MD, MSc, FIDSA; Jennifer Loveless, MPH; Rebecca L. Morgan, PhD, MPH; and Rajesh T. Gandhi, MD, FIDSA.  

About IDSA
The Infectious Diseases Society of America is a community of over 13,000 physicians, scientists and public health experts who specialize in infectious diseases. Its purpose is to improve the health of individuals, communities and society by promoting excellence in patient care, education, research, public health and prevention relating to infectious diseases. Learn more at idsociety.org.

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