TY - JOUR
T1 - Safety of intramuscular tixagevimab-cilgavimab (Evusheld®) administration in patients at risk of iatrogenic haematoma due to haematological disorders
AU - Malherbe, Jacques A.J.
AU - Misko, Jeanie
AU - Jayawardena, Nishani K.
AU - Rawlins, Matthew D.M.
AU - Manning, Laurens
AU - Purtill, Duncan
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/9/17
Y1 - 2024/9/17
N2 - Introduction: Traditionally, intramuscular (IM) injections have been avoided in patients with haematological diseases due to the risk of iatrogenic haematoma. Tixagevimab-cilgavimab (Evusheld®) is a novel monoclonal antibody combination used as preexposure prophylaxis against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for those at highest risk of severe infections. It is delivered as two separate IM injections (1.5 mL each). Patients with haematological disease are at higher risk for severe SARS-CoV-2 infections, which may be partially abrogated by the prophylactic inoculation of tixagevimab-cilgavimab. Methods: A combined retrospective and prospective study of patients under the haematology service at a large metropolitan hospital receiving tixagevimab-cilgavimab was conducted. Tixagevimab-cilgavimab was administered IM to all patients, with platelet and factor replacement provided according to local protocols. Patients completed a numerical pain score daily for seven days following the injection, with scores ≥4/10 prompting an ultrasound to identify iatrogenic gluteal haematomas. Results: The study recruited 131 patients; 66 patients were thrombocytopenic, including 10 patients with a platelet count <30 × 109/L. Fourteen patients (10.7%) received a single platelet transfusion prior to tixagevimab-cilgavimab administration, while two patients received fresh frozen plasma. No gluteal haematomas were identified, and only two patients reported an initial pain score of ≥4/10. Conclusions: The intramuscular administration of tixagevimab-cilgavimab in patients with haematological diseases was well tolerated and was not associated with iatrogenic haematoma.
AB - Introduction: Traditionally, intramuscular (IM) injections have been avoided in patients with haematological diseases due to the risk of iatrogenic haematoma. Tixagevimab-cilgavimab (Evusheld®) is a novel monoclonal antibody combination used as preexposure prophylaxis against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for those at highest risk of severe infections. It is delivered as two separate IM injections (1.5 mL each). Patients with haematological disease are at higher risk for severe SARS-CoV-2 infections, which may be partially abrogated by the prophylactic inoculation of tixagevimab-cilgavimab. Methods: A combined retrospective and prospective study of patients under the haematology service at a large metropolitan hospital receiving tixagevimab-cilgavimab was conducted. Tixagevimab-cilgavimab was administered IM to all patients, with platelet and factor replacement provided according to local protocols. Patients completed a numerical pain score daily for seven days following the injection, with scores ≥4/10 prompting an ultrasound to identify iatrogenic gluteal haematomas. Results: The study recruited 131 patients; 66 patients were thrombocytopenic, including 10 patients with a platelet count <30 × 109/L. Fourteen patients (10.7%) received a single platelet transfusion prior to tixagevimab-cilgavimab administration, while two patients received fresh frozen plasma. No gluteal haematomas were identified, and only two patients reported an initial pain score of ≥4/10. Conclusions: The intramuscular administration of tixagevimab-cilgavimab in patients with haematological diseases was well tolerated and was not associated with iatrogenic haematoma.
KW - Haematoma
KW - Thrombocytopenia
KW - Tixagevimab-cilgavimab
UR - http://www.scopus.com/inward/record.url?scp=85204436187&partnerID=8YFLogxK
U2 - 10.1177/10781552241284944
DO - 10.1177/10781552241284944
M3 - Article
C2 - 39285732
AN - SCOPUS:85204436187
SN - 1078-1552
JO - Journal of Oncology Pharmacy Practice
JF - Journal of Oncology Pharmacy Practice
ER -