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- Title
Sotrovimab: A Review of Its Efficacy against SARS-CoV-2 Variants.
- Authors
Focosi, Daniele; Casadevall, Arturo; Franchini, Massimo; Maggi, Fabrizio
- Abstract
Among the anti-Spike monoclonal antibodies (mAbs), the S-309 derivative sotrovimab was the most successful in having the longest temporal window of clinical use, showing a high degree of resiliency to SARS-CoV-2 evolution interrupted only by the appearance of the BA.2.86* variant of interest (VOI). This success undoubtedly reflects rational selection to target a highly conserved epitope in coronavirus Spike proteins. We review here the efficacy of sotrovimab against different SARS-CoV-2 variants in outpatients and inpatients, discussing both randomized controlled trials and real-world evidence. Although it could not be anticipated at the time of its development and introduction, sotrovimab's use in immunocompromised individuals who harbor large populations of variant viruses created the conditions for its eventual demise, as antibody selection and viral evolution led to its eventual withdrawal due to inefficacy against later variant lineages. Despite this, based on observational and real-world data, some authorities have continued to promote the use of sotrovimab, but the lack of binding to newer variants strongly argues for the futility of continued use. The story of sotrovimab highlights the power of modern biomedical science to generate novel therapeutics while also providing a cautionary tale for the need to devise strategies to minimize the emergence of resistance to antibody-based therapeutics.
- Subjects
SARS-CoV-2; CORONAVIRUS spike protein; MEDICAL sciences; VIRAL antibodies; IMMUNOCOMPROMISED patients
- Publication
Viruses (1999-4915), 2024, Vol 16, Issue 2, p217
- ISSN
1999-4915
- Publication type
Article
- DOI
10.3390/v16020217