脏范围蛋白尿:一个潜在的风险因素,导致tixagevimab-cilgavimab预防失败
Ayman Al Jurdi1,2,3, Christopher El Mouhayyar2, Orhan Efe2,3
1Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA.
Journal of nephrology
|September 2, 2023
概括
脏范围蛋白尿可能会降低 tixagevimab-cilgavimab (Evusheld) 预防 SARS-CoV-2 感染的有效性. 患有蛋白尿症的患者经历了更多突破性感染,这表明潜在的治疗失败.
科学领域:
- 免疫学 免疫学 免疫学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 提克萨吉维马布-西尔加维马布 (Evusheld) 用于针对SARS-CoV-2的暴露前预防,特别是在免疫受损的个体中.
- 脏范围蛋白尿可能导致免疫球蛋白的损失,可能降低抗体预防的疗效,如 tixagevimab-cilgavimab.
- 没有先前的研究研究了脏范围蛋白尿与 tixagevimab-cilgavimab 预防失败之间的联系.
研究的目的:
- 评估脏范围蛋白尿症与txagevimab-cilgavimab在预防SARS-CoV-2感染方面的有效性之间的关联.
- 为了确定患有脏范围蛋白尿症的患者是否经历了突破性SARS-CoV-2感染的更高率,尽管接受了 tixagevimab-cilgavimab.
主要方法:
- 进行了一项回顾性观察性队列研究.
- 鉴定了接受txagevimab-cilgavimab,脏范围蛋白尿症的患者,并与对照患者匹配1:3.
- 匹配标准包括B细胞枯竭疗法,总剂量,以及施用tixagevimab-cilgavimab的日期. 主要结局是突破性的SARS-CoV-2感染.
主要成果:
- 十六名患有脏范围蛋白尿症的患者接受了 tixagevimab-cilgavimab.
- 与对照组相比,发症组呈现出较高的蛋白尿和肌素,以及较低的专蛋白水平.
- 在随访的中位数时,38%的脏病患者群体发生突破性SARS-CoV-2感染,对照组为13% (日志排名P = 0.04).
结论:
- 脏范围蛋白尿与 tixagevimab-cilgavimab 预防失败的风险增加有关.
- 需要进一步的前性研究来证实这些发现.
- 在患有脏范围蛋白尿症的患者中,基于抗体的预防的最佳剂量策略需要研究.
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