Monoclonal antibody therapies against SARS-CoV-2

Daniele Focosi; Scott McConnell; Arturo Casadevall; Emiliano Cappello; Giulia Valdiserra; Marco Tuccori

doi:10.1016/S1473-3099(22)00311-5

Monoclonal antibody therapies against SARS-CoV-2

Lancet Infect Dis. 2022 Nov;22(11):e311-e326. doi: 10.1016/S1473-3099(22)00311-5. Epub 2022 Jul 5.

Authors

Daniele Focosi¹, Scott McConnell², Arturo Casadevall², Emiliano Cappello³, Giulia Valdiserra³, Marco Tuccori⁴

Affiliations

¹ North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy.
² Department of Medicine, Johns Hopkins School of Public Health and School of Medicine, Baltimore, MD, USA.
³ Unit of Adverse Drug Reactions Monitoring, Pisa University Hospital, Pisa, Italy; Unit of Pharmacology and Pharmacovigilance, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
⁴ Unit of Pharmacology and Pharmacovigilance, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: marco.tuccori@gmail.com.

Abstract

Monoclonal antibodies (mAbs) targeting the spike protein of SARS-CoV-2 have been widely used in the ongoing COVID-19 pandemic. In this paper, we review the properties of mAbs and their effect as therapeutics in the pandemic, including structural classification, outcomes in clinical trials that led to the authorisation of mAbs, and baseline and treatment-emergent immune escape. We show how the omicron (B.1.1.529) variant of concern has reset treatment strategies so far, discuss future developments that could lead to improved outcomes, and report the intrinsic limitations of using mAbs as therapeutic agents.

Publication types

Review

MeSH terms

Antibodies, Monoclonal / therapeutic use
Antibodies, Neutralizing
Antibodies, Viral / therapeutic use
COVID-19*
Humans
Pandemics
SARS-CoV-2*
Spike Glycoprotein, Coronavirus

Substances

Spike Glycoprotein, Coronavirus
Antibodies, Monoclonal
Antibodies, Viral
Antibodies, Neutralizing
spike protein, SARS-CoV-2