DOI record:
{
"DOI": "10.1093/cid/ciae408",
"ISSN": [
"1058-4838",
"1537-6591"
],
"URL": "http://dx.doi.org/10.1093/cid/ciae408",
"abstract": "<jats:title>Abstract</jats:title>\n <jats:p>The COVID-19 pandemic saw the largest deployment of monoclonal antibodies (mAbs) for an infectious disease in history. mAbs to SARS-CoV-2 spike protein proved safe and were initially effective for COVID-19 therapy, but each was defeated by continued SARS-CoV-2 evolution, leading to their withdrawal. This was a setback for people with impaired immunity who cannot mount an effective antibody response to SARS-CoV-2 and often cannot clear the virus. New mAbs have now been developed for pre-exposure prophylaxis (PreEP) in immunosuppressed people. Here we argue that while mAb use for PreEP is justified, single mAbs should not be used for COVID-19 therapy. In contrast to PreEP where the viral inoculum is small, immunosuppressed people with COVID-19 have large viral burden that can harbor mAb-escape variants that single-agent mAb treatments can rapidly select for resistance. Selection of mAb-escape variants has potential risks for patients, society and the feasibility of mAb therapy itself.</jats:p>",
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"ORCID": "http://orcid.org/0000-0002-9402-9167",
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"name": "Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health , Baltimore, MD"
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"family": "Casadevall",
"given": "Arturo",
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{
"affiliation": [
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"name": "North-Western Tuscany Blood Bank, Pisa University Hospital , Pisa , Italy"
}
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"family": "Focosi",
"given": "Daniele",
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{
"affiliation": [
{
"name": "Divison of Infectious Diseases, Albert Einstein College of Medicine , Bronx, NY"
}
],
"family": "Pirofski",
"given": "Liise-anne",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Division of Infectious Diseases, Johns Hopkins School of Medicine , Baltimore, MD"
}
],
"family": "Shoham",
"given": "Shmuel",
"sequence": "additional"
}
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"publisher": "Oxford University Press (OUP)",
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"URL": "https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciae408/7729969"
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"source": "Crossref",
"subject": [],
"subtitle": [],
"title": "Single monoclonal antibodies should not be used for COVID-19 therapy: a call for antiviral stewardship",
"type": "journal-article"
}
