Omicron: what we know about Xevudy, the new treatment against Covid-19 authorized in France by the Haute Autorité de Santé

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Xevudy, the new synthetic antibody treatment against Covid-19, has just been authorized in France by the Haute Autorité de Santé. Based on the sotrovimab molecule, it is judged by the French health authorities to be effective against the Omicron variant.

On January 6, the French National Authority for Health authorized treatment with synthetic antibodies, Xevudy, based on the sotrovimab molecule. French health authorities consider it promising against the Omicron variant. Xevudy is intended for patients over 12 years old, who have just been infected with Covid-19 and are considered to be at risk of severe form. We take stock of this treatment.

What category of the population is affected?

This monoclonal treatment active against Omicron, developed by the pharmaceutical company Glaxo Smith Kline, will be intended for adults and adolescents, aged 12 years and over and weighing at least 40 kg, with Covid-19, do not require supplementation in oxygen but which may progress to a severe form of Covid-19.

The ANRS-Emerging Infectious Diseases has therefore drawn up a list of these patients:

  • Patients 80 years of age and over,
  • Patients with an immunity deficit linked to a pathology or to treatments:
    • Chemotherapy in progress,
    • Solid organ transplantation,
    • Allogeneic hematopoietic stem cell transplantation,
    • Systemic or vascular lupus with immunosuppressive treatment,
    • Corticosteroid treatment> 10 mg / day of prednisone equivalent for more than 2 weeks,
    • Immunosuppressive therapy including rituximab.
  • Patients at risk of complications:
    • Obese (BMI> 30 kg / m²),
    • COPD and chronic respiratory failure,
    • Complicated high blood pressure,
    • Heart failure,
    • Diabetes (type 1 and type 2),
    • Chronic renal failure,
    • Other chronic pathologies.

According to the Haute Autorité de Santé, “this indication is liable to change depending on the state of scientific knowledge and the epidemiological context”.

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How is it administered?

This monoclonal treatment is administered intravenously within five days of the onset of the first symptoms. “Sotrovimab is a monoclonal antibody entirely of human origin with double action: a neutralizing action by preventing the virus from infecting new cells, and a powerful effector action by killing already infected cells” reports the Haute Autorité de Santé.

This treatment “presents a mechanism of action which makes it possible to hope for the maintenance of its efficacy on variants, including the Omicron variant, according to the HAS. In vitro data suggest the maintenance of the neutralizing activity of sotrovimab when that of other available monoclonal antibodies decrease or even disappear. “

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Is it better than the previous treatments?

Xevudy is one of the synthetic antibody treatments. Others before him have been authorized since the start of the pandemic. Since last March, Ronapreve has been used for the same indication. However, in January, French health authorities stopped recommending it in the event of an infection with Omicron. However, he remains authorized against the Delta variant. Eli Lilly’s bamlanivimab / etesivimab combination was completely withdrawn from circulation after disappointing results against Delta.

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