MHRA (UK) grants conditional marketing authorisation for COVID-19 treatment Xevudy.
It is recommended that Xevudy is administered within 5 days of onset of symptoms of COVID-19. In the coming weeks, UK patients at increased risk of severe complications of COVID-19 will be able to access sotrovimab following a supply agreement reached earlier with the UK government. The Conditional Marketing Authorisation covers England, Scotland, and Wales. Supply of sotrovimab in Northern Ireland is enabled under the regulation 174 of the Human Medicines Regulations 2012.
The design of sotrovimab, a monoclonal antibody, is based on the natural antibodies humans already make. In clinical trials sotrovimab was shown to significantly reduce the risk of hospitalisation or death among high-risk adult outpatients with mild to moderate COVID-19. The final analysis from the COMET-ICE trial demonstrated a 79% reduction (adjusted relative risk reduction 95% CI, p<0.001; sotrovimab (6 528 [1%]) vs placebo (30 529 [6%]) in hospitalisation for more than 24 hours or death due to any cause (by day 29) compared to placebo. sotrovimab has been well tolerated in clinical studies conducted to date. the most common adverse reactions are hypersensitivity reactions, seen in approximately 2% of cases.
Sotrovimab binds to an epitope on SARS-CoV-2 that is shared with SARS-CoV-1 (the virus that causes SARS), indicating that the epitope is conserved, which may make it more difficult for resistance to develop. This indicates potential for sotrovimab to be effective across multiple variants of concern. Updated in vitro data, published in bioRxiv (the pre-print server for biology) demonstrate that sotrovimab retains activity against all current tested variants of concern and interest of the SARS-CoV-2 virus as defined by the World Health Organisation (WHO), plus others, including, but not limited to, Delta (B.1.617.2), Delta Plus (AY.1 or AY.2) and Mu (B.1.621). Based on the sequence of the Omicron variant, we believe sotrovimab is likely to maintain activity and potency against this variant.
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