Tixagevimab and Cilgavima Safe, Effective in Patients With MS on B-Cell Depleters

Preexposure prophylaxis for SARS-CoV-2 infection with tixagevimab and cilgavimab was safe and effective at preventing severe symptomatic COVID-19 in patients with MS receiving B-cell depleters.

Tixagevimab co-packaged with cilgavimab may be a safe and effective strategy for preventing severe, symptomatic COVID-19 disease among patients with multiple sclerosis (MS) who are receiving B-cell depleters. These study findings were presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2023, held in San Diego, California, from February 23 to 25.

B-cell depleting therapies are common in the setting of MS but can affect the protective response from vaccination, which has been a particular concern during the COVID-19 pandemic. Tixagevimab and cilgavimab is approved for SARS-CoV-2 infection preexposure prophylaxis among patients who are immunosuppressed.

For the study, a researcher from The Comprehensive MS Center at Methodist Hospitals in the United States evaluated the safety and efficacy of tixagevimab and cilgavimab for preventing symptomatic COVID-19 among B-cell depleter recipients with MS. Patients (N=26) with MS who were receiving ocrelizumab or ofatumumab at Methodist Hospitals and were given 150 or 300 mg tixagevimab and cilgavimab prophylaxis were evaluated for the occurrence and severity of COVID-19 infections up to 6 months after tixagevimab and cilgavimab administration.

A total of 5 patients reported a symptomatic COVID-19 infection within 6 months of receiving tixagevimab and cilgavimab. Among symptomatic cases, 2 patients had received the 150 mg dose and 3 patients received the 300 mg dose.

In this small cohort of MS patients on B-cell depleters, Evusheld was demonstrated to be both safe and effective at preventing symptomatic COVID-19.

All symptomatic cases were of mild, grades 1 or 2, severity.

Side effects from tixagevimab and cilgavimab were reported by 2 patients and all observed side effects were mild.

The limitations of this study included the single center design and small sample size.

The researchers concluded, “In this small cohort of MS patients on b-cell depleters, Evusheld [tixagevimab and cilgavimab] was demonstrated to be both safe and effective at preventing symptomatic COVID-19.”

Additional larger studies are needed to confirm these findings in this patient population.


Conte WL. Clinical efficacy and safety of tixagevimab and cilgavimab (Evusheld) on preventing COVID-19 in patients with MS on B-cell depleters. Presented at: ACTRIMS Forum 2023; February 23-25; San Diego, CA. Poster 103.