Tixagevimab and Cilgavimab (Evusheld) as Pre-exposure Prophylaxis for COVID-19 in Patients With Inflammatory Bowel Disease: A Propensity Matched Cohort Study
MD, * Aakash Desai, MD, MSc Jana G Hashash, MD Gursimran S Kochhar, MD, MSc Francis A Farraye
Crohn's & Colitis 360, doi:10.1093/crocol/otad047
Background: Tixagevimab and cilgavimab (Evusheld) are 2 fully human monoclonal antibodies that received emergency-use authorization on December 21, 2021, for pre-exposure prophylaxis of coronavirus disease 2019 (COVID-19) in patients who are moderate-severely immunocompromised. The real-world efficacy of Evusheld in patients with inflammatory bowel disease (IBD) is not known.
Methods: We conducted a retrospective cohort study using TriNetX, a multi-institutional database in patients with IBD who received Evusheld compared to patients with IBD who did not receive Evusheld (12.1.2021-10.28.2022). The primary outcome was to assess the risk of COVID-19 within 6 months. One-to-one propensity score matching (PSM) was performed for demographic parameters, comorbid conditions, IBD medications, and history of COVID-19. Risk was expressed as adjusted odds ratio (aOR) with 95% confidence interval (CI). Results: Four hundred and eight patients (0.19%) with IBD received Evusheld (mean age 58.6 ± 15.4 years old, female 47.7%) during the study period. After PSM, there was no difference in the risk (aOR 0.88, 95% CI, 0.33-2.35) of COVID-19 in the Evusheld cohort compared to the IBD control cohort. No patients required ICU care or intubation/respiratory support or were deceased in the Evusheld cohort. Conclusions: Our study did not show that Evusheld decreases the risk of COVID-19 in patients with IBD. Prevention of moderate-severe COVID-19 in these patients should focus on vaccination strategies and early COVID-19 therapies.
Author Contributions A.D.: Data collection, data analysis and preparation of manuscript. J.G.H. and G.S.K.: Data interpretation and critical revision of the manuscript. F.A.F.: Study conceptualization, data interpretation, critical revision, and final approval of the manuscript.
Conflicts of Interest A.D.: None exists. J.G.H. holds the position of Associate Editor for Crohn's & Colitis 360 and has been recused from reviewing or making decisions for the manuscript. G.S.K.: Advisor Board: Corvetas Research Foundation, Lilly Pharmaceuticals, GIE medical; Stock options: Digbi Health. F.A.F. is a consultant for BMS, Braintree Labs, GSK, IBD Educational Group, Innovation Pharmaceuticals, Janssen, Pfizer and Sebela. He sits on a DSMB for Adiso Therapeutics and Lilly.
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