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Omicron variant BQ.1.1: nirmatrelvir + ritonavir retains activity, monoclonal antibodies do not

 COVID-19  The Sars-CoV-2 circulating in France as of December 2022 is the BQ.1.1 sublineage of Omicron variant BA.5. To what degree does this affect the possible benefits of treatment with Sars-CoV-2-specific monoclonal antibodies or the combination of nirmatrelvir + ritonavir (Paxlovid°)? A few studies have provided some answers to this question.

A Japanese team tested several drugs in vitro for their neutralising activity against the BQ.1.1 sublineage of Omicron variant BA.5. Among the monoclonal antibodies targeting the spike protein of Sars-CoV-2, and known to have marked in-vitro neutralising activity against an ancestral strain of this virus, several had no or barely any effect on this sublineage: the combinations of tixagevimab + cilgavimab (Evusheld°) and casirivimab + imdevimab (Ronapreve°), and sotrovimab (Xevudy°). They are therefore likely to have greatly reduced clinical efficacy against infections with sublineage BQ.1.1...

©Prescrire 1 April 2023

Source: "Omicron variant BQ.1.1: nirmatrelvir + ritonavir retains activity, monoclonal antibodies do not" Prescrire International 2023; 32(247): 94-95. Subscribers only.

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"Nirmatrelvir + ritonavir (Paxlovid°)
in covid-19” 
(June 2022)
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