Efficacy and safety of sotrovimab in patients with COVID‐19: A rapid review and meta‐analysis

Abstract

The therapeutic potential of sotrovimab in the treatment of coronavirus disease 2019 (COVID‐19) is a controversial issue. The aim of this study was to evaluate the efficacy and safety of sotrovimab in COVID‐19 patients. To this end, PubMed, Cochrane Library, Embase, Web of Science, medRxiv, and Google Scholar were searched up to 15 August 2022. The reference lists of key studies were also scanned to find additional records. Meta‐analysis was performed using Comprehensive Meta‐Analysis. Seventeen studies involving 27,429 patients were included. A significant difference was observed in mortality rate (odds ratio [OR] = 0.40; 95% CI: 0.25–0.63, p = 0.00), hospitalisation rate (OR = 0.53; 95% CI: 0.43–0.65. p = 0.00), hospital or death rate (OR = 0.43; 95% CI: 0.25–0.73, p = 0.00), the need for mechanical ventilation (OR = 0.57; 95% CI: 0.33–0.96, p = 0.03), and ICU admission (OR = 0.33; 95% CI: 0.17–0.67, p = 0.00) of the sotrovimab‐receiving group compared to those having no sotrovimab. However, no significant difference was observed between the two groups in terms of disease progression (OR = 0.45; 95% CI: 0.16–1.24, p = 0.12) and emergency department visit (OR = 1.01; 95% CI: 0.83–1.24, p = 0.87). The two groups had no significant difference in terms of incidence of adverse events (OR = 0.98; 95% CI: 0.78–1.23, p = 0.88). The findings of the present meta‐analysis support that sotrovimab could be an effective and safe treatment option to reduce mortality and hospitalisation rate in both Delta and Omicron Variants of COVID‐19.

Efficacy and safety of regdanvimab in patients with mild to moderate COVID‐19: A rapid review and meta‐analysis

“…In general, mAb therapies have been found to be safe and well tolerated in COVID-19 patients. 37,38 The present study has several important limitations. First, most studies included in the meta-analysis were retrospective, subjecting the results to increased risk of bias and higher heterogeneity.…”

“…This finding is in line with Marcec et al 36 who found that the use of regdanvimab in patients with COVID-19 is not associated with a significant benefit in mortality rate. However, other metaanalyses [37][38][39] have indicated that mAb treatments may reduce mortality rate in patients with COVID-19 infection. The mAb agents may reduce mortality rate in COVID-19 patients through targeting the receptor binding domain of the SARS-CoV-2 spike glycoprotein.…”

“…40 However, their efficacy against the Omicron variant of SARS-CoV-2 is currently debated. 41 Although, other anti-SARS-COV-2 mAbs such as sotrovimab 37 have been found to be effective against the Omicron variant, their treatment potential may be affected by novel variants in the future. 41 Out of all studies included in the present meta-analysis, only 2 studies evaluated and showed the efficacy of regdanvimab in patients infected with the Omicron variant.…”

“…Our findings showed no significant clinical benefit in the use of regdanvimab to prevent disease progression and reduce the need for mechanical ventilation in patients with COVID‐19 compared with the controls. However, meta‐analyses 37,46 of other mAb treatments showed different efficacies for disease progression and need for mechanical ventilation in COVID‐19 patients. This difference may be due to the fact that COVID‐19 patients treated with different mAb regimens show various clinical outcomes 47 …”

“…The present meta‐analysis revealed the similar incidence of adverse events between patients receiving regdanvimab and those who did not received regdanvimab. In general, mAb therapies have been found to be safe and well tolerated in COVID‐19 patients 37,38 …”