Table 2 FDA approvals (monoclonal antibodies) [20]

Casirivimab and Imdevimab

2020/11/21 EUA

2021/08/10 EUA (post exposure prophylaxis)

– Developer—Regeneron

– Brand name—REGEN-COV

– Type—Neutralizing antibody

– Mechanism—binds to RBD of the spike protein of SARS-CoV-2 and blocks its attachment to human ACE2 receptors, thereby preventing the entry of virus in the human cells. [34]

– Activity profile—A cocktail of mAbs (casirivimab and imdevimab), REGEN-COV reduces the viral load (SARS-CoV-2). The combination also decreases the number of medical visits of COVID-19 patients. [35]

Mild to medium, adult and child (> 12 yr)

Severe and high risk of adult and child (> 12 yr or 40 kg) prevention [20]

Bamlanivimab and Etesevimab

2021/02/09 EUA

2021/06/25 (Suspension) EUA

2021/08/27 (resume) EUA

2021/09/16 EUA (Post-exposure prophylaxis)

– Developer—Eli Lilly

– Type—Neutralizing antibody

– Mechanism—binds to RBD of the spike protein of SARS-CoV-2

– Activity profile—the combination could lower the incidence of hospitalization and death (COVID-19 related) as compared to placebo was evidenced with the combination of bamlanivimab plus etesevimab. Treatment with the combination also led to a decline in the SARS-CoV-2 viral load [36]

Mild to medium, adult and child (> 12 yr)

Severe and high risk of adult and child (> 12 yr or 40 kg), prophylaxis [20]

Sotrovimab

2021/05/26 EUA

– Developer—GSK/ Vir Biotechnology

– Brand name—Xevudy

– Type—Neutralizing antibody

– Mechanism—the antibody binds to a highly conserved epitope on the spike (S) protein (SARS-CoV-2) [37]

– Activity Profile—In a study, treatment with the antibody reduced the risk of a composite end point of all-cause hospitalization or death [38]

Medium to severe, Adult and child (> 12 yr) [20]

Tocilizumab

2021/06/24 EUA

– Developer—Genentech

– Brand Name—Actemra

– Type—IL-6 monoclonal antibody

– Mechanism—competitive inhibition of IL-6 binding to its receptor (IL-6R). [39]

– Activity—Treatment with IL-6 monoclonal antibody reduces the progression likelihood to the composite outcome of mechanical ventilation or death in COVID-19 hospitalized patients with pneumonia [39]. Tocilizumab attenuates the inflammatory response in the cytokine storm [40]

Hospitalized, severe cases, adult and child (> 2 yr) [20]

Tixagevimab and& Cilgavimib

12/08/2021 EUA

– Developer—AsterZeneca

– Brand name—Evusheld

– Type—Neutralizing antibody

– Mechanism—the antibody binds to the spike protein (non-overlapping portions, SARS-CoV-2)

– Activity profile—The combination of antibodies (Tixagevimab plus cilgavimab) administered IM lowered the incidence of symptomatic COVID-19 in comparison to placebo. Administration of combination (every six months, Tixagevimab and cilgavimab) to eligible patients is recommended in case SARS-CoV-2 is in circulation. The cocktail of neutralizing antibodies is efficacious against the delta variant of SARS-CoV-2 [41]

Adult and child (> 12 yr or

40 kg), Prophylaxis [20]

Bebtelovimab

02/11/2022 EUA

– Developer—Eli Lilly

– Type—Neutralizing IgG1 monoclonal antibody

– Mechanism—Binds to spike protein of SARS-CoV-2

– Activity profile—Studies have demonstrated the retention of neutralization efficacy against all variants of SARS-CoV-2 except Mu variant. Notably, bebtelovimab retains the efficacy against SARS-CoV-2 omicron variants [42, 43]

Severe high risk and mild to medium, adult and child (> 12 yr or 40 kg) [20]