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Collaborative treatment Sotrovimab can cause drug resistance mutations, studies have found | Coronavirus
Australian virologists say that if a drug-resistant mutation in the Covid-19 virus associated with a drug called sotrovimab is discovered and the treated patients are not monitored, the mutated virus can spread to the community. increase.
World’s first survey results, Published Thursday in The New England Journal of MedicineIs the results of an analysis of the first 100 patients in western Sydney who received sotrovimab during the 2021 delta outbreak.
Sotrovimab is a monoclonal antibody available in many countries to treat vulnerable patients at risk of serious illness or death due to Covid-19 infection. Sotrovimab should be administered by infusion within the first 5 days of Covid-19 infection to prevent the symptoms of Covid-19 from becoming severe. It is one of the few human-operated monoclonal antibodies that can target Omicron.
Dr. Rebecca Rocket, the lead author of the study, stated that four patients developed resistance to sotrovimab 6 to 13 days after treatment. Whole-genome sequences of the virus analyzed from patients before and after sotrovimab treatment revealed mutations in a small number of patients who “effectively inactivated the drug,” according to Rocket of the University of Sydney Institute for Infectious Diseases. ..
“I don’t know if sotrovimab helps neutralize the virus before it develops resistance in the early stages of infection. However, in many cases, drugs are given to treat Covid-19 patients, and in fact We know that not all patients can be followed by PCR tests or genomic surveillance, but for treatments that use genomics to determine if they have acquired resistant mutations. Nevertheless, we are trying to defend patients who progress to serious illness. “
Even after the patient obtained the mutations, Rocket and her team were able to take samples from them and propagate the virus in the laboratory, so it was important to monitor them. This meant that patients were at risk of transmitting the mutated virus to others.
“What we don’t want to see is a resistant virus that is widespread in the community, which means that many other people can’t use this drug either.”
Rockett said it would be wise for those who resisted quarantining longer until the virus was cleared and would make a special effort to stay away from people in the same household. The virus persisted in affected patients for up to 24 days after sotrovimab treatment.
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This represents the first report of tolerance to sotrovimab in patients.
Professor Peter Collignon, an infectious disease doctor and drug resistance expert at the Australian National University, said the potential spread of resistant viruses in the community represents a “real problem.”
“Thankfully, this mutation looks like a relatively rare event, but the only way to know it is to monitor it.”
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