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Evusheld Covid antibody treatment - what you need to know

23rd Mar 2022 - Rachel Kahn

Find out more about the Covid antibody treatment Evusheld (formely AZD7442), which consists of two long-acting antibodies called tixagevumab and cilgavimab.

On 17th March 22, Evusheld was licensed for use in the UK by the Medicines and Health Products Regulatory Agency (MHRA), the organisation that approves new drugs for use in the UK.

Evusheld is a treatment that has been shown to reduce the risk of people developing or becoming seriously ill from Covid. It is made up of two kinds of antibody called tixagevimab and cilgavimab. It is made by the pharmaceutical company AstraZeneca and has been tested in the UK on a clinical trial called PROVENT.

The drug has been shown to reduce the risk of developing symptomatic Covid by 77% in a group of people where 75% had health issues that put them at higher risk of Covid infection, although this trial took place before Omicron emerged which may affect this. No one on the trial who received Evusheld became seriously ill from Covid and people tolerated the treatment well.

For most people, the best way to prevent infection is vaccination. Evusheld has been approved for use in adults who are unlikely to develop a good immune response from covid vaccination or for people who cannot be vaccinated. Some people with blood cancer do not respond as well to the Covid vaccines as their immune systems are weaker than people without blood cancer. For these people, Evusheld may give them protection from Covid.

Will people with blood cancer be able to have Evusheld?

As the MHRA have approved the drug, it can be now used in the UK to prevent Covid. The Department of Health and Social Care hasn’t yet announced how many doses of the drug it plans to buy from AstraZeneca, or who it plans to offer the drug to, but we hope it will order some doses of the drug in the coming weeks. We’ll keep you updated when we hear more.

As of 19th October 2022, Evusheld is being made available privately in the UK. We have more information about accessing Evusheld privately, and what we are doing to lobby for free access.

Will Evusheld work against Omicron?

In the PROVENT trial, Evusheld reduced the risk of developing symptomatic Covid by 77%, but this data was collected before Omicron emerged. This means at this stage, we can’t be sure how well Evusheld works at preventing Omicron. This will need to be studied, as will be the case for any future Covid variants that arise.

Researchers have looked at this question in the lab and think that Evusheld should still work against Omicron, although it might not work as well as it did against previous strains of Covid. It may be that people are offered a higher dose of Evusheld than participants on the PROVENT trial received, to give them the best possible chance of protection from Covid. This is something that will continue to be monitored and we will share more when we hear it.

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How long will the treatment last and how is it given?

It’s thought that one dose of Evusheld can give protection against Covid for six months. We’re not sure at this stage what dose of the drug people will receive, as this may change if Evusheld is found to be less effective against Omicron. It will be given as two injections into a muscle.

When will it be rolled out?

At the moment, we don’t know when Evusheld will start being used in the UK, or who will be entitled to the drug. We are speaking to government officials to try and find out more about this and will update you when we know more.

Should I get my 5th vaccine if it gives me antibodies that might rule me out of getting Evusheld?

As we don’t know when Evusheld will be rolled out, or who will receive it, it’s important you still get your 5th vaccine dose as this will give you the best chance of getting protection from Covid. If you are entitled to Evusheld, it’s likely that your treating team will work with you to work out the most effective time for you to receive the drug after your last vaccine. At this stage, we don’t think everyone with blood cancer will receive Evusheld and think it’s likely to only be offered to those at highest risk of Covid. We’re also not sure how people will be selected for the treatment, but we’ll update you when we know more.

Who will be responsible for allocating, prescribing and dispensing Evusheld?

We’re unsure of the details of how Evusheld will be rolled out at the moment but will update you when we know more.

Is there anyone who shouldn’t have Evusheld?

Both antibodies are given in the muscle with the following: histidine, histidine hydrochloride monohydrate, sucrose, polysorbate 80 and water. If you are known to have a reaction to any of these ingredients, it may be that you are advised not to have Evusheld. If you’re worried that you might be sensitive to one of these ingredients and you are offered Evusheld, you should speak to your clinician.

Is there an alternative plan for those who cannot receive it and who have no measurable Covid antibodies?

We hope that people who do not generate antibodies following vaccination will be offered Evusheld, but we don’t yet know who will be entitled to the drug. If you aren’t offered Evusheld and you have no measurable antibodies after vaccination it doesn’t mean you don’t have any protection from Covid, and you should keep getting your vaccines. Antibodies are the cheapest and easiest way to find out if someone has had a vaccine response. However, other cells such as T cells provide protection from Covid. People who don’t have antibodies following vaccination may still have T cells which would protect them from the virus.

People with blood cancer who test positive for covid are also eligible for new covid treatments including antivirals and antibodies.

Can I pay privately if it's doesn't get NHS funding?

Our best understanding at the moment is that any doses of Evusheld that the UK buys will have been purchased by the UK government and therefore will only be made available on the NHS and will not be available privately. If this changes, we will update you.

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