Table A. SARS-CoV-2 Variants Currently or Recently Circulating in the United States and Their Susceptibility to Anti-SARS-CoV-2 Monoclonal Antibodies

Last Updated: March 6, 2023

See the Guidelines Archive for information on bamlanivimab plus etesevimab, casirivimab plus imdevimab, and variants that were previously circulating in the United States.

Table A. SARS-CoV-2 Variants Currently or Recently Circulating in the United States and Their Susceptibility to Anti-SARS-CoV-2 Monoclonal Antibodies
WHO Label and Pango Lineage	BEB		TIX Plus CIL		SOT
WHO Label and Pango Lineage	In Vitro Susceptibility^a	Anticipated Clinical Activity	In Vitro Susceptibility^a	Anticipated Clinical Activity	In Vitro Susceptibility^a	Anticipated Clinical Activity
Omicron BA.5	No change	Active	Moderate reduction	Active	Marked reduction	Unlikely to be active
Omicron BA.4.6/BF.7	No change	Active	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active
Omicron BQ.1	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active
Omicron BQ.1.1	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active
Omicron XBB	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active
Omicron XBB.1.5	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active	Marked reduction	Unlikely to be active
^a This information is based on the fold reduction in susceptibility reported in the FDA EUAs^1-3 and in vitro neutralization studies.^4-9 Key: BEB = bebtelovimab; CIL = cilgavimab; EUA = Emergency Use Authorization; FDA = Food and Drug Administration; SOT = sotrovimab; TIX = tixagevimab; WHO = World Health Organization

References

Food and Drug Administration. Fact sheet for healthcare providers: Emergency Use Authorization (EUA) of sotrovimab. 2022. Available at: https://www.fda.gov/media/149534/download.
Food and Drug Administration. Fact sheet for healthcare providers: Emergency Use Authorization for Evusheld (tixagevimab co-packaged with cilgavimab). 2023. Available at: https://www.fda.gov/media/154701/download.
Food and Drug Administration. Fact sheet for healthcare providers: Emergency Use Authorization for bebtelovimab. 2022. Available at: https://www.fda.gov/media/156152/download.
Imai M, Ito M, Kiso M, et al. Efficacy of antiviral agents against Omicron subvariants BQ.1.1 and XBB. N Engl J Med. 2023;388(1):89-91. Available at: https://www.ncbi.nlm.nih.gov/pubmed/36476720.
Wang Q, Iketani S, Li Z, et al. Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants. Cell. 2023;186(2):279-286.e8. Available at: https://www.ncbi.nlm.nih.gov/pubmed/36580913.
Takashita E, Yamayoshi S, Halfmann P, et al. In vitro efficacy of antiviral agents against Omicron subvariant BA.4.6. N Engl J Med. 2022;387(22):2094-2097. Available at: https://pubmed.ncbi.nlm.nih.gov/36383452/.
Wang Q, Li Z, Ho J, et al. Resistance of SARS-CoV-2 Omicron subvariant BA.4.6. to antibody neutralisation. Lancet Infect Dis. 2022;22(12):1666-1668. Available at: https://pubmed.ncbi.nlm.nih.gov/36328002/.
Takashita E, Yamayoshi S, Simon V, et al. Efficacy of antibodies and antiviral drugs against Omicron BA.2.12.1, BA.4, and BA.5 subvariants. N Engl J Med. 2022;387(5):468-470. Available at: https://www.ncbi.nlm.nih.gov/pubmed/35857646.
Wang Q, Guo Y, Iketani S, et al. Antibody evasion by SARS-CoV-2 Omicron subvariants BA.2.12.1, BA.4 and BA.5. Nature. 2022;608(7923):603-608. Available at: https://pubmed.ncbi.nlm.nih.gov/35790190/.