Fc-engineered antibody therapeutics with improved anti-SARS-CoV-2 efficacy.

Publication Type Academic Article
Authors Yamin R, Jones A, Hoffmann H, Schäfer A, Kao K, Francis R, Sheahan T, Baric R, Rice C, Ravetch J, Bournazos S
Journal Nature
Volume 599
Issue 7885
Pagination 465-470
Date Published 09/21/2021
ISSN 1476-4687
Keywords Antibodies, Monoclonal, COVID-19, Immunoglobulin Fc Fragments, SARS-CoV-2, COVID-19 Drug Treatment
Abstract Monoclonal antibodies with neutralizing activity against SARS-CoV-2 have demonstrated clinical benefits in cases of mild-to-moderate SARS-CoV-2 infection, substantially reducing the risk for hospitalization and severe disease1-4. Treatment generally requires the administration of high doses of these monoclonal antibodies and has limited efficacy in preventing disease complications or mortality among hospitalized patients with COVID-195. Here we report the development and evaluation of anti-SARS-CoV-2 monoclonal antibodies with optimized Fc domains that show superior potency for prevention or treatment of COVID-19. Using several animal disease models of COVID-196,7, we demonstrate that selective engagement of activating Fcγ receptors results in improved efficacy in both preventing and treating disease-induced weight loss and mortality, significantly reducing the dose required to confer full protection against SARS-CoV-2 challenge and for treatment of pre-infected animals. Our results highlight the importance of Fcγ receptor pathways in driving antibody-mediated antiviral immunity and exclude the possibility of pathogenic or disease-enhancing effects of Fcγ receptor engagement of anti-SARS-CoV-2 antibodies upon infection. These findings have important implications for the development of Fc-engineered monoclonal antibodies with optimal Fc-effector function and improved clinical efficacy against COVID-19 disease.
DOI 10.1038/s41586-021-04017-w
PubMed ID 34547765
PubMed Central ID PMC9038156
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