The emergence of SARS-CoV-2 and subsequent COVID-19 pandemic has resulted in a significant global public health burden, leading to an urgent need for effective therapeutic strategies. In this article, we review the role of SARS-CoV-2 neutralizing antibodies (nAbs) in the clinical management of COVID-19 and provide an overview of recent randomized controlled trial data evaluating nAbs in the ambulatory, hospitalized and prophylaxis settings. Two nAb cocktails (casirivimab/imdevimab and bamlanivimab/etesevimab) and one nAb monotherapy (bamlanivimab) have been granted Emergency Use Authorization by the US Food and Drug Administration for the treatment of ambulatory patients who have a high risk of progressing to severe disease, and the European Medicines Agency has similarly recommended both cocktails and bamlanivimab monotherapy for use in COVID-19 patients who do not require supplemental oxygen and who are at high risk of progressing to severe COVID-19. Efficacy of nAbs in hospitalized patients with COVID-19 has been varied, potentially highlighting the challenges of antiviral treatment in patients who have already progressed to severe disease. However, early data suggest a promising prophylactic role for nAbs in providing effective COVID-19 protection. We also review the risk of treatment-emergent antiviral resistant “escape” mutants and strategies to minimize their occurrence, discuss the susceptibility of newly emerging SARS-COV-2 variants to nAbs, as well as explore administration challenges and ways to improve patient access.
【저자키워드】 COVID-19, neutralizing antibody, SARS-CoV-2, bamlanivimab, Casirivimab, Imdevimab, resistance, etesevimab, 【초록키워드】 Randomized controlled trial, Treatment, Hospitalized, severe COVID-19, Antiviral, susceptibility, COVID-19 pandemic, variant, risk, oxygen, drug, Antiviral treatment, Prophylactic, hospitalized patients, Emergency use authorization, bamlanivimab, European Medicines Agency, Prophylaxis, Casirivimab, Imdevimab, etesevimab, Patient, Therapeutic strategies, Clinical management, mutant, monotherapy, SARS-CoV-2 neutralizing antibodies, SARS-CoV-2 neutralizing antibody, NAb, food, administration, Emergency, severe disease, COVID-19 patient, high risk, supplemental oxygen, US Food and Drug Administration, ambulatory patients, global public health, NAbs, Drug administration, authorization, effective, IMPROVE, Occurrence, subsequent, hospitalized patient, highlighting, ambulatory patient, progressed, with COVID-19, 【제목키워드】 Therapeutics,