An evaluation of sipavibart for pre-exposure prophylaxis of COVID-19 in immunocompromised individuals

Sipavibart was the first monoclonal antibody to show efficacy and safety in preventing symptomatic COVID-19 among immunocompromised individuals, protecting for up to six months. However, the widespread circulation of variants harboring S:F456L currently limits its clinical utility, and use should be restricted. Maintaining access to Sipavibart remains justified, as future antigenic shifts could restore its activity. Its deployment should rely on genomic surveillance and local epidemiology. At the same time, next-generation mAbs should prioritize conserved spike regions and multi-epitope cocktails to counter viral evolution and prolong therapeutic value.