Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 Vaccines
<b><i>Background</i></b> Sotrovimab, a monoclonal antibody against SARS-CoV-2, is used as a pre-exposition prophylaxis (PrEP) against COVID-19, but monitoring strategies using routine test systems have not been defined. <b><i>Methods</i></b> Twenty kid...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-07-01
|
| Series: | Viruses |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1999-4915/15/8/1624 |
| _version_ | 1797583095945232384 |
|---|---|
| author | Constantin Aschauer Andreas Heinzel Karin Stiasny Christian Borsodi Karin Hu Jolanta Koholka Wolfgang Winnicki Alexander Kainz Helmuth Haslacher Rainer Oberbauer Roman Reindl-Schwaighofer Lukas Weseslindtner |
| author_facet | Constantin Aschauer Andreas Heinzel Karin Stiasny Christian Borsodi Karin Hu Jolanta Koholka Wolfgang Winnicki Alexander Kainz Helmuth Haslacher Rainer Oberbauer Roman Reindl-Schwaighofer Lukas Weseslindtner |
| author_sort | Constantin Aschauer |
| collection | DOAJ |
| description | <b><i>Background</i></b> Sotrovimab, a monoclonal antibody against SARS-CoV-2, is used as a pre-exposition prophylaxis (PrEP) against COVID-19, but monitoring strategies using routine test systems have not been defined. <b><i>Methods</i></b> Twenty kidney transplant recipients without antibodies after vaccination received 500 mg Sotrovimab. Antibody levels were quantified over eight weeks using live-virus neutralization (BA1 and BA2), antibody binding assays (TrimericS, Elecsys, QuantiVAC) and surrogate virus neutralization tests (sVNTs; TECOmedical, cPass and NeutraLISA). <b><i>Results</i></b> Sotrovimab neutralized both Omicron subvariants (BA1 NT titer 90 (+−50) > BA2 NT titer 33 (+−15) one hour post infusion). Sotrovimab was measurable on all used immunoassays, although a prior 1:100 dilution was necessary for Elecsys due to a presumed prozone effect. The best correlation with live-virus neutralization titers was found for QuantiVAC and TrimericS, with a respective R<sup>2</sup> of 0.65/0.59 and 0.76/0.57 against BA1/BA2. Elecsys showed an R<sup>2</sup> of 0.56/0.54 for BA1/BA2, respectively. sVNT values increased after infusion but had only a poor correlation with live-virus neutralization titers (TECOmedical and cPass) or did not reach positivity thresholds (NeutraLISA). <b><i>Conclusion</i></b> Antibody measurements by the used immunoassays showed differences in antibody levels and only a limited correlation with neutralization capacity. We do not recommend sVNTs for monitoring SARS-CoV-2 neutralization by Sotrovimab. |
| first_indexed | 2024-03-10T23:31:01Z |
| format | Article |
| id | doaj.art-c28ec08993af4a73b42cc3446cc45741 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-10T23:31:01Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-c28ec08993af4a73b42cc3446cc457412023-11-19T03:19:20ZengMDPI AGViruses1999-49152023-07-01158162410.3390/v15081624Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 VaccinesConstantin Aschauer0Andreas Heinzel1Karin Stiasny2Christian Borsodi3Karin Hu4Jolanta Koholka5Wolfgang Winnicki6Alexander Kainz7Helmuth Haslacher8Rainer Oberbauer9Roman Reindl-Schwaighofer10Lukas Weseslindtner11Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaCenter of Virology, Medical University of Vienna, 1090 Vienna, AustriaCenter of Virology, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, 1090 Vienna, AustriaCenter of Virology, Medical University of Vienna, 1090 Vienna, Austria<b><i>Background</i></b> Sotrovimab, a monoclonal antibody against SARS-CoV-2, is used as a pre-exposition prophylaxis (PrEP) against COVID-19, but monitoring strategies using routine test systems have not been defined. <b><i>Methods</i></b> Twenty kidney transplant recipients without antibodies after vaccination received 500 mg Sotrovimab. Antibody levels were quantified over eight weeks using live-virus neutralization (BA1 and BA2), antibody binding assays (TrimericS, Elecsys, QuantiVAC) and surrogate virus neutralization tests (sVNTs; TECOmedical, cPass and NeutraLISA). <b><i>Results</i></b> Sotrovimab neutralized both Omicron subvariants (BA1 NT titer 90 (+−50) > BA2 NT titer 33 (+−15) one hour post infusion). Sotrovimab was measurable on all used immunoassays, although a prior 1:100 dilution was necessary for Elecsys due to a presumed prozone effect. The best correlation with live-virus neutralization titers was found for QuantiVAC and TrimericS, with a respective R<sup>2</sup> of 0.65/0.59 and 0.76/0.57 against BA1/BA2. Elecsys showed an R<sup>2</sup> of 0.56/0.54 for BA1/BA2, respectively. sVNT values increased after infusion but had only a poor correlation with live-virus neutralization titers (TECOmedical and cPass) or did not reach positivity thresholds (NeutraLISA). <b><i>Conclusion</i></b> Antibody measurements by the used immunoassays showed differences in antibody levels and only a limited correlation with neutralization capacity. We do not recommend sVNTs for monitoring SARS-CoV-2 neutralization by Sotrovimab.https://www.mdpi.com/1999-4915/15/8/1624preexposition prophylaxismonoclonal antibodiesSARS-CoV-2pharmakokinetics |
| spellingShingle | Constantin Aschauer Andreas Heinzel Karin Stiasny Christian Borsodi Karin Hu Jolanta Koholka Wolfgang Winnicki Alexander Kainz Helmuth Haslacher Rainer Oberbauer Roman Reindl-Schwaighofer Lukas Weseslindtner Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 Vaccines Viruses preexposition prophylaxis monoclonal antibodies SARS-CoV-2 pharmakokinetics |
| title | Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 Vaccines |
| title_full | Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 Vaccines |
| title_fullStr | Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 Vaccines |
| title_full_unstemmed | Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 Vaccines |
| title_short | Monitoring of Sotrovimab-Levels as Pre-Exposure Prophylaxis in Kidney Transplant Recipients Not Responding to SARS-CoV-2 Vaccines |
| title_sort | monitoring of sotrovimab levels as pre exposure prophylaxis in kidney transplant recipients not responding to sars cov 2 vaccines |
| topic | preexposition prophylaxis monoclonal antibodies SARS-CoV-2 pharmakokinetics |
| url | https://www.mdpi.com/1999-4915/15/8/1624 |
| work_keys_str_mv | AT constantinaschauer monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT andreasheinzel monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT karinstiasny monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT christianborsodi monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT karinhu monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT jolantakoholka monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT wolfgangwinnicki monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT alexanderkainz monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT helmuthhaslacher monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT raineroberbauer monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT romanreindlschwaighofer monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines AT lukasweseslindtner monitoringofsotrovimablevelsaspreexposureprophylaxisinkidneytransplantrecipientsnotrespondingtosarscov2vaccines |