Emerging anti-spike monoclonal antibodies against SARS-CoV-2

Area of Science:

• Immunology and Virology
• Therapeutic Antibody Development

Background:

• Previously authorized anti-spike monoclonal antibodies (mAbs) for COVID-19 are no longer effective against current SARS-CoV-2 Omicron variants.
• This renders them unavailable for immunocompromised patients who previously benefited from them.

Purpose of the Study:

• To summarize emerging anti-spike monoclonal antibodies (mAbs) in early clinical development.
• To assess their safety, efficacy, and potential to overcome SARS-CoV-2 evolution.

Main Methods:

• Review of early-stage clinical trial data for novel anti-spike mAbs.
• Analysis of engineered features, such as prolonged half-life and combination therapies.
• Evaluation of novel administration routes and applications, including long COVID treatment.

Main Results:

• Emerging mAbs demonstrate good tolerability and safety in early trials.
• Engineering strategies aim to prolong half-life and combine mAbs to counter resistance.
• Novel applications include inhaled administration and treatment for long COVID.

Conclusions:

• Novel anti-spike mAbs hold promise for immunocompromised patients, building on prior successes.
• Continued SARS-CoV-2 evolution and escape mutations pose challenges.
• Developing interventions to ensure sustained activity of these agents is crucial for future COVID-19 management.