Impact of Bamlanivimab Monoclonal Antibody Treatment on Hospitalization and Mortality Among Nonhospitalized Adults With Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Abstract

Background Monoclonal antibody treatment may prevent complications of COVID-19. We sought to quantify the impact of bamlanivimab monoclonal antibody monotherapy on hospitalization and mortality among outpatients at high risk of COVID-19 complications. Methods In this observational study we compared outpatients who received bamlanivimab monoclonal antibody from December 9, 2020 to March 3, 2021 to non-treated patients with a positive polymerase chain reaction or antigen test for SARS-CoV-2 during the same period who were eligible for monoclonal antibody treatment. The primary outcome was 28-day hospitalization or all-cause mortality, and the secondary outcome was hospitalization or emergency department visit without hospitalization. The risk-adjusted odds of study outcomes comparing bamlanivimab treated and untreated patients was determined using 1:5 propensity matching and multivariable logistic regression. Results Among 232 patients receiving bamlanivimab matched with 1,160 comparator patients, the mean age was 67 years, 56% were female, and 196 (14%) of patients experienced hospitalization or mortality. After adjustment for propensity to receive treatment, bamlanivimab treatment was associated with a significantly reduced risk-adjusted odds of hospitalization or mortality within 28 days (OR 0.40, 95% confidence interval [95% CI] 0.24 to 0.69; p<.001). Bamlanivimab treatment was also associated with a significantly lower risk adjusted odds of hospitalization or emergency department visit without hospitalization (OR 0.54, 95% CI 0.35 to 0.82; p=.004). The results were most strongly associated with patients age 65 years and older. Conclusions Bamlanivimab monoclonal antibody monotherapy was associated with reduced hospitalizations and mortality within 28 days among outpatients with mild-moderate COVID-19.

Bamlanivimab improves hospitalization and mortality rates in patients with COVID-19: A systematic review and meta-analysis

“…48 studies were identified for full-text review and 40 studies were excluded because they had no comparison groups between Bamlanivimab treatment and control or outcomes were not available. A total of 8 studies [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] comprising of 13573 adult patients with COVID-19, including 4191 in the BAM (administered alone) and 9382 in the control group arm, were included in this meta-analysis.…”

A Review of Treatment and Prevention of Coronavirus Disease 2019 among Solid Organ Transplant Recipients

“…Real-world data surrounding the use of monoclonal antibody among SOT recipients is sparse. In an observational study comparing outpatients who received bamlanivimab with non-treated patients, bamlanivimab was associated with fewer hospitalizations and mortality within 28 days [ 25 ]. This study included 12 SOT recipients but outcomes were not reported specific to this group.…”

A Learning Health System Randomized Trial of Monoclonal Antibodies for Covid-19

“…Physicians review with patients the EUA Fact Sheet for each mAB and explain they could be assigned any of the EUA-governed mABs. 2-4…”

“…Neutralizing monoclonal antibodies (mAb) targeting SARS-CoV-2 were granted U.S. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for treatment of mild to moderate Covid-19, and significantly decrease hospitalization and death in this patient population. [1][2][3][4][5][6][7][8][9] However, clinical use is limited due to lack of access, logistical challenges of administration, and incomplete clinician and patient awareness. 10 The comparative effectiveness of one mAb versus another is also unknown.…”