Sotrovimab, a Monoclonal antibody already approved for mild to moderate COVID-19 in several countries gets approval by MHRA in the UK. This antibody was intelligently designed with a mutating virus in mind. A highly conserved region of the spike protein was targeted that is less likely to mutate, with a hope to address both the previous and current variants of SARS-CoV-2 virus (Omicron) and the future variants, that would be inevitable.
Xeduvy (sotrovimab), a monoclonal antibody made in collaboration between GSK and Vir Biotechnology which has already been approved for mild to moderate COVID-19 patients in several countries (Australia, Canada, USA), was recently given market authorization by MHRA, UK1 for use in COVID-19 patients within 5 days of the onset of infection. It was found to be safe and effective and reduced the risk of hospitalisation by 79%. The key feature of sotrovimab is that it is targeted against a highly conserved region of the spike protein of SARS-CoV-2, that is less likely to mutate. This region of SARS-CoV-2 is shared with SARS-CoV-1 (the virus that causes SARS)2, indicating that the region is highly conserved, thereby making it more difficult for resistance to develop. This feature makes sotrovimab to work against all the variants of COVID-19 available so far, including Omicron. It should also work on any future variants as well, as long as the mutations do not occur in the conserved region3 of the spike protein of SARS-CoV-2, which has not been seen till now.
Sotrovimab can thus act as a magic bullet against the all known and future unknown variants (that are inevitable as virus accumulates more mutations by higher transmission) of COVID-19. The principle of developing sotrovimab by targeting the conserved region of the spike protein, can be exploited for further development of monoclonal antibodies and vaccines against COVID-19.
- GSK 2021. Press releases – MHRA grants conditional marketing authorisation1 for COVID-19 treatment Xevudy (sotrovimab). Published 02 December 2021. Available at https://www.gsk.com/en-gb/media/press-releases/mhra-grants-conditional-marketingauthorisation1-for-covid-19-treatment-xevudy-sotrovimab/
- GSK 2021. Press releases – Preclinical data demonstrate sotrovimab retains activity against key Omicron mutations, new SARS-CoV-2 variant. Published 02 December 2021. Available at https://www.gsk.com/en-gb/media/press-releases/preclinical-data-demonstratesotrovimab-retains-activity-against-key-omicron-mutations-new-sars-cov-2-variant/
- Pinto, D., Park, YJ., Beltramello, M. et al. Cross-neutralization of SARS-CoV-2 by a human monoclonal SARS-CoV antibody. Nature 583, 290–295 (2020). https://doi.org/10.1038/s41586-020-2349-y