卡西维单抗和依德维单抗作为COVID-19患者的实验性单克隆抗体-文献综述

IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Current Issues in Pharmacy and Medical Sciences Pub Date : 2021-09-01 DOI:10.2478/cipms-2021-0030
G. Ręka, Angelika Pawlak, P. Machowiec, Marcela Maksymowicz, Halina Piecewicz-Szczęsna
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摘要

摘要Casirivimab和imdevimab(REGN-COV-2)是美国食品药品监督管理局于2020年11月批准用于轻度和中度新冠肺炎紧急使用的研究单克隆抗体。这两种非竞争性的人IgG1单克隆抗体可以靶向严重急性呼吸系统综合征冠状病毒2型刺突蛋白的受体结合结构域,阻止其进入人体细胞,并降低病毒载量。抗体可以静脉注射给不需要住院和补充氧气的轻度至中度新冠肺炎患者。该研究的目的是审查使用casirivimab和imdevimab治疗新冠肺炎的最新可用数据。根据最近的临床前研究,抗体混合物具有最佳的抗病毒强度,并有可能将病毒逃逸的机会降至最低。动物研究表明,该混合物可以减少病毒引起的病理后果,减少呼吸系统中的病毒数量,并降低肺部滴度和肺炎症状。Casirivimab和imdevimab作为混合物也可以防止耐药突变体的快速出现。在临床试验中,REGN-COV-2降低了病毒载量,特别是在未启动免疫反应(血清抗体阴性)和基线时病毒载量高的患者中。REGN-COV2联合剂量组(2.4克和8.0克)和安慰剂组的不良反应相当。这种鸡尾酒的毒性作用很少,而且主要是低级别的。Casirivimab和imdevimab似乎是新冠肺炎非住院患者的有效和安全的抗病毒治疗。进一步的观察和研究对于在更广泛的患者群体中评估疗效、安全性和适应症是非常必要的。
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Casirivimab and imdevimab as investigational monoclonal antibodies for COVID-19 patients – review of the literature
Abstract Casirivimab and imdevimab (REGN-COV-2) are investigational monoclonal antibodies approved in November 2020 by the Food and Drug Administration for emergency use in mild and moderate COVID-19. These two noncompeting human IgG1 monoclonal antibodies can target the receptor-binding domain of the spike protein of SARSCoV-2, prevent its entry into human cells, and reduce viral load. The antibodies can be administered intravenously for mild-to-moderate COVID-19 patients who do not require hospitalization and supplemental oxygen. The purpose of the study is to review the latest available data on COVID-19 treatment using casirivimab and imdevimab. According to recent preclinical studies, the antibody cocktail presents optimal antiviral strength and has the potential to minimize the chances of the virus escaping. It was shown in animal studies that the cocktail reduces the pathological consequences caused by viruses, decreases the number of viruses in the respiratory system, and reduces lung titers and pneumonia symptoms. Casirivimab and imdevimab as a cocktail also prevents the rapid appearance of treatment-resistant mutants. In the clinical trial, REGN-COV-2 decreased viral load, particularly in patients with a non-initiated immune response (serum antibody-negative) and with high viral load at baseline. The adverse effects were comparable in the combined REGN-COV2 dose groups (2.4 g and 8.0 g), as well as in the placebo group. The cocktail caused few and mainly low-grade toxic effects. Casirivimab and imdevimab seem to be effective and safe antiviral therapy for nonhospitalized patients with COVID-19. Further observations and research are extremely necessary to assess the efficacy, security and indications in a wider group of patients.
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来源期刊
Current Issues in Pharmacy and Medical Sciences
Current Issues in Pharmacy and Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
0.80
自引率
0.00%
发文量
28
审稿时长
16 weeks
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