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Monoclonal antibody levels and protection from COVID-19

Author

Listed:
  • Eva Stadler

    (University of New South Wales)

  • Martin T. Burgess

    (University of New South Wales)

  • Timothy E. Schlub

    (University of Sydney)

  • Shanchita R. Khan

    (University of New South Wales)

  • Khai Li Chai

    (Monash University)

  • Zoe K. McQuilten

    (Monash University
    Monash Health)

  • Erica M. Wood

    (Monash University
    Monash Health)

  • Mark N. Polizzotto

    (The Australian National University
    Canberra Region Cancer Centre, The Canberra Hospital)

  • Stephen J. Kent

    (University of Melbourne at the Peter Doherty Institute for Infection and Immunity
    Monash University)

  • Deborah Cromer

    (University of New South Wales)

  • Miles P. Davenport

    (University of New South Wales)

  • David S. Khoury

    (University of New South Wales)

Abstract

Multiple monoclonal antibodies have been shown to be effective for both prophylaxis and therapy for SARS-CoV-2 infection. Here we aggregate data from randomized controlled trials assessing the use of monoclonal antibodies (mAb) in preventing symptomatic SARS-CoV-2 infection. We use data on the in vivo concentration of mAb and the associated protection from COVID-19 over time to model the dose-response relationship of mAb for prophylaxis. We estimate that 50% protection from COVID-19 is achieved with a mAb concentration of 96-fold of the in vitro IC50 (95% CI: 32—285). This relationship provides a tool for predicting the prophylactic efficacy of new mAb and against SARS-CoV-2 variants. Finally, we compare the relationship between neutralization titer and protection from COVID-19 after either mAb treatment or vaccination. We find no significant difference between the 50% protective titer for mAb and vaccination, although sample sizes limited the power to detect a difference.

Suggested Citation

  • Eva Stadler & Martin T. Burgess & Timothy E. Schlub & Shanchita R. Khan & Khai Li Chai & Zoe K. McQuilten & Erica M. Wood & Mark N. Polizzotto & Stephen J. Kent & Deborah Cromer & Miles P. Davenport &, 2023. "Monoclonal antibody levels and protection from COVID-19," Nature Communications, Nature, vol. 14(1), pages 1-9, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-40204-1
    DOI: 10.1038/s41467-023-40204-1
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    References listed on IDEAS

    as
    1. Dami A. Collier & Isabella A. T. M. Ferreira & Prasanti Kotagiri & Rawlings P. Datir & Eleanor Y. Lim & Emma Touizer & Bo Meng & Adam Abdullahi & Anne Elmer & Nathalie Kingston & Barbara Graves & Emma, 2021. "Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2," Nature, Nature, vol. 596(7872), pages 417-422, August.
    2. Deborah Cromer & Megan Steain & Arnold Reynaldi & Timothy E. Schlub & Shanchita R. Khan & Sarah C. Sasson & Stephen J. Kent & David S. Khoury & Miles P. Davenport, 2023. "Predicting vaccine effectiveness against severe COVID-19 over time and against variants: a meta-analysis," Nature Communications, Nature, vol. 14(1), pages 1-9, December.
    3. Katherine McMahan & Jingyou Yu & Noe B. Mercado & Carolin Loos & Lisa H. Tostanoski & Abishek Chandrashekar & Jinyan Liu & Lauren Peter & Caroline Atyeo & Alex Zhu & Esther A. Bondzie & Gabriel Dagott, 2021. "Correlates of protection against SARS-CoV-2 in rhesus macaques," Nature, Nature, vol. 590(7847), pages 630-634, February.
    4. Dean Follmann & Meagan P. O’Brien & Jonathan Fintzi & Michael P. Fay & David Montefiori & Allyson Mateja & Gary A. Herman & Andrea T. Hooper & Kenneth C. Turner & Kuo- Chen Chan & Eduardo Forleo-Neto , 2023. "Examining protective effects of SARS-CoV-2 neutralizing antibodies after vaccination or monoclonal antibody administration," Nature Communications, Nature, vol. 14(1), pages 1-9, December.
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    Cited by:

    1. Matthew T. Berry & Shanchita R. Khan & Timothy E. Schlub & Adriana Notaras & Mohana Kunasekaran & Andrew E. Grulich & C. Raina MacIntyre & Miles P. Davenport & David S. Khoury, 2024. "Predicting vaccine effectiveness for mpox," Nature Communications, Nature, vol. 15(1), pages 1-11, December.

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