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In Vitro Efficacy of Antivirals and Monoclonal Antibodies against SARS-CoV-2 Omicron Lineages XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1

Pochtovyi et al., Vaccines, doi:10.3390/vaccines11101533
Sep 2023  
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17th treatment shown to reduce risk in March 2021
*, now known with p = 0.0000087 from 27 studies, recognized in 42 countries. Efficacy is variant dependent.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,900+ studies for 60+ treatments.
In Vitro study showing sharply reduced neutralization of SARS-CoV-2 variants XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1 with monoclonal antibodies cilgavimab, tixagevimab, imdevimab, etsevimab, casirivimab, bamlanivimab, and regdanvimab. Only sotrovimab retained measurable, though reduced neutralizing activity.
Efficacy was retained for remdesivir, molnupiravir, and nirmatrelvir, however IC50 values for remdesivir were ~3 times higher for XBB.1.* variants compared with B.1.1, BQ.1.1.45, CL.1, CH.1.1, and XBB.2.9, and the IC50 for nirmatrelvir for XBB.2.9 was ~2 times higher compared with previous variants.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants Haars, Liu, Pochtovyi, Sheward, Tatham, VanBlargan.
Pochtovyi et al., 28 Sep 2023, peer-reviewed, 16 authors, study period September 2022 - May 2023. Contact: (corresponding author),,
In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
This PaperCasirivimab/i..All
In Vitro Efficacy of Antivirals and Monoclonal Antibodies against SARS-CoV-2 Omicron Lineages XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1
Andrei A Pochtovyi, Daria D Kustova, Andrei E Siniavin, Inna V Dolzhikova, Elena V Shidlovskaya, Olga G Shpakova, Lyudmila A Vasilchenko, Arina A Glavatskaya, Nadezhda A Kuznetsova, Anna A Iliukhina, Artem Y Shelkov, Olesia M Grinkevich, Andrei G Komarov, Denis Y Logunov, Vladimir A Gushchin, Alexander L Gintsburg
Vaccines, doi:10.3390/vaccines11101533
The spread of COVID-19 continues, expressed by periodic wave-like increases in morbidity and mortality. The reason for the periodic increases in morbidity is the emergence and spread of novel genetic variants of SARS-CoV-2. A decrease in the efficacy of monoclonal antibodies (mAbs) has been reported, especially against Omicron subvariants. There have been reports of a decrease in the efficacy of specific antiviral drugs as a result of mutations in the genes of non-structural proteins. This indicates the urgent need for practical healthcare to constantly monitor pathogen variability and its effect on the efficacy of preventive and therapeutic drugs. As part of this study, we report the results of the continuous monitoring of COVID-19 in Moscow using genetic and virological methods. As a result of this monitoring, we determined the dominant genetic variants and identified the variants that are most widespread, not only in Moscow, but also in other countries. A collection of viruses from more than 500 SARS-CoV-2 isolates has been obtained and characterized. The genetic lines XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1, representing the greatest concern, were identified among the dominant variants. We studied the in vitro efficacy of mAbs Tixagevimab + Cilgavimab (Evusheld), Sotrovimab, Regdanvimab, Casirivimab + Imdevimab (Ronapreve), and Bebtelovimab, as well as the specific antiviral drugs Remdesivir, Molnupiravir, and Nirmatrelvir, against these genetic lines. At the current stage of the COVID-19 pandemic, the use of mAbs developed against early SARS-CoV-2 variants has little prospect. Specific antiviral drugs retain their activity, but further monitoring is needed to assess the risk of their efficacy being reduced and adjust recommendations for their use.
Conflicts of Interest: The authors declare no conflict of interest.
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