The Medical Letter on Drugs and Therapeutics
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ISSUE
1654
COVID-19 Update: Hypersensitivity Reactions with Tixagevimab/Cilgavimab (Evusheld)
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Med Lett Drugs Ther. 2022 Jul 11;64(1654):112
Disclosures
Principal Faculty
  • Mark Abramowicz, M.D., President: no disclosure or potential conflict of interest to report
  • Jean-Marie Pflomm, Pharm.D., Editor in Chief: no disclosure or potential conflict of interest to report
  • Brinda M. Shah, Pharm.D., Consulting Editor: no disclosure or potential conflict of interest to report
Additional Contributor(s)
  • Michael Viscusi, Pharm.D., Associate Editor: no disclosure or potential conflict of interest to report
Objective(s)
Upon completion of this activity, the participant will be able to:
  1. Discuss the new warnings about the risk of hypersensitivity reactions with use of tixagevimab/cilgavimab (Evusheld).
 Select a term to see related articles  cilgavimab   COVID-19   Evusheld   tixagevimab 

The labeling for the investigational, long-acting, prophylactic anti-SARS-CoV-2 monoclonal antibodies tixagevimab and cilgavimab (Evusheld; available under an FDA Emergency Use Authorization) now includes warnings about a risk of serious hypersensitivity reactions, including anaphylaxis, with use of the drugs, particularly in patients who have experienced a hypersensitivity reaction to a COVID-19 vaccine.1,2

Evusheld contains polysorbate 80, an emulsifying agent similar in structure to polyethylene glycol (PEG). Both polysorbate and PEG can cause hypersensitivity reactions, and all of the COVID-19 vaccines currently available in the US (Pfizer/BioNTech, Moderna, Johnson & Johnson/Janssen) contain either polysorbate or PEG. Patients who have experienced a hypersensitivity reaction to a COVID-19 vaccine may be more likely to experience another after receiving Evusheld.1

According to the new labeling, tixagevimab/cilgavimab should be administered in a setting that is equipped to manage severe hypersensitivity reactions. Patients should be monitored for at least 1 hour after the antibodies are injected. Clinicians should consider consulting with an allergist-immunologist before administering Evusheld to a patient who has had a severe hypersensitivity reaction to a COVID-19 vaccine.1

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