Clin Transplant Res.  2024 Jun;38(2):136-144. 10.4285/ctr.24.0015.

Tixagevimab/cilgavimab prophylaxis against COVID-19 in solid organ transplant recipients: a systematic review and meta-analysis

• Khorramnia S
• Navidi Z
• Orandi A
• Iravani MM
• Orandi A
• Malekabad ES
• Moghadam SHP

• KMID: 2557607
• DOI: http://doi.org/10.4285/ctr.24.0015

Abstract

Background
Tixagevimab/cilgavimab (Tix/Cil) shows promise as a prophylactic treatment against coronavirus disease 2019 (COVID-19) in solid organ transplant recipients (SOTRs). This study was performed to assess the effectiveness of Tix/Cil for preexposure prophylaxis against COVID-19 in this population.
Methods
We systematically searched the Cochrane Library, Web of Science, PubMed, and Embase databases to identify articles relevant to our study up to December 15, 2023. Comprehensive Meta-Analysis (ver. 3.0) was used for data analysis.
Results
The meta-analysis included seven eligible retrospective studies, encompassing a total of 4,026 SOTRs. The analysis revealed significant differences in SOTRs who received Tix/Cil preexposure prophylaxis relative to those who did not. Specifically, these differences were observed in the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.15–0.60), hospitalization (OR, 0.24; 95% CI, 0.08–0.70), and intensive care unit admission (OR, 0.07; 95% CI, 0.02–0.22). However, mortality rate did not differ significantly between the two groups (P=0.06).
Conclusions
The evidence supporting the effectiveness of Tix/Cil as preexposure prophylaxis against SARS-CoV-2 in SOTRs is of a low to moderate level. Further high-quality research is necessary to understand its effects on this population.

Keyword

COVID-19; SARS-CoV-2; Organ transplantation; Preexposure prophylaxis; Cilgavimab and tixagevimab drug combination

Figure

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  Fig. 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.

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  Fig. 2 Forest plot of severe acute respiratory syndrome coronavirus 2 infection in the tixagevimab/cilgavimab (Tix/Cil) and control groups. CI, confidence interval.

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  Fig. 3 Forest plot of mortality rate in the tixagevimab/cilgavimab (Tix/Cil) and control groups. CI, confidence interval.

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  Fig. 4 Forest plot of hospitalization rate in the tixagevimab/cilgavimab (Tix/Cil) and control groups.

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  Fig. 5 Forest plot of intensive care unit admission rate in the tixagevimab/cilgavimab (Tix/Cil) and control groups.

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