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Table A. SARS-CoV-2 Variants and Susceptibility to Anti-SARS-CoV-2 Monoclonal Antibodies

Last Updated: August 18, 2022

Table A. SARS-CoV-2 Variants and Susceptibility to Anti-SARS-CoV-2 Monoclonal Antibodies

Table A. SARS-CoV-2 Variants and Susceptibility to Anti-SARS-CoV-2 Monoclonal Antibodies
Years of CirculationWHO Label and Pango LineageNotable MutationsBEBTIX Plus CILBAM Plus ETECAS Plus IMDSOT
In Vitro SusceptibilityaAnticipated Clinical ActivityIn Vitro SusceptibilityaAnticipated Clinical ActivityIn Vitro SusceptibilityaAnticipated Clinical ActivityIn Vitro SusceptibilityaAnticipated Clinical ActivityIn Vitro SusceptibilityaAnticipated Clinical Activity
Variants Currently or Recently Circulating in the United States
2021–presentOmicron BA.2T376A, K417N, N440K, E484A, Q493R, N501YNo changeActiveNo changeActiveMarked reductionUnlikely to be activeMarked reductionUnlikely to be activeMarked reductionUnlikely to be active
2022–presentOmicron BA.4BA.2 plus del69/70, L452R, F486V, Q493 reversionNo changeActiveModerate reductionbActivecMarked reductionUnlikely to be activeMarked reductionUnlikely to be activeMarked reductionUnlikely to be active
2022–presentOmicron BA.5BA.2 plus del69/70, L452R, F486V, Q493 reversionNo changeActiveModerate reductionbActivecMarked reductionUnlikely to be activeMarked reductionUnlikely to be activeMarked reductionUnlikely to be active
Variants That Are Not Currently Circulating in the United States
2020–2021Alpha B.1.1.7N501YNo changeActiveNo changeActiveNo changeActiveNo changeActiveNo changeActive
2020–2021Beta B.1.351K417N, E484K, N501YNo changeActiveNo changeActiveMarked reductionUnlikely to be activeNo changedActiveNo changeActive
2020–2021Gamma P.1K417T, E484K, N501YNo changeActiveNo changeActiveMarked reductionUnlikely to be activeNo changedActiveNo changeActive
2020–2021Delta B.1.617.2, non-AY.1/AY.2L452R, T478KNo changeActiveNo changeActiveNo changeActiveNo changeActiveNo changeActive
2021–2022Omicron B.1.1.529/ BA.1K417N, N440K, G446S, E484A, Q493R, N501YNo changeActiveModerate reductionbActivecMarked reductionUnlikely to be activeMarked reductionUnlikely to be activeNo changeActive
2021–2022Omicron BA.1.1BA.1 plus R346KNo changeActiveModerate reductionbActivecMarked reductionUnlikely to be activeMarked reductionUnlikely to be activeNo changeActive

a Based on the fold reduction in susceptibility reported in the FDA EUAs.6,16,24,25
b Despite the moderately reduced in vitro susceptibility of TIX plus CIL, in vitro PK/PD modeling data suggest that the TIX 300 mg plus CIL 300 mg dose will retain activity against the Omicron VOC.16
c The duration of activity for TIX plus CIL against these subvariants is not well defined. TIX plus CIL should be given in repeat doses every 6 months if ongoing protection is needed.
d Marked change for CAS and no change for IMD. The combination of CAS plus IMD appears to retain activity against the variant.

 

Key: BAM = bamlanivimab; BEB = bebtelovimab; CAS = casirivimab; CIL = cilgavimab; ETE = etesevimab; EUA = Emergency Use Authorization; FDA = Food and Drug Administration; IMD = imdevimab; PK/PD = pharmacokinetic/pharmacodynamic; SOT = sotrovimab; TIX = tixagevimab; WHO = World Health Organization


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