Real-world clinical outcomes of treatment with casirivimab-imdevimab among patients with mild-to-moderate coronavirus disease 2019 during the Delta variant pandemic

Abstract

Background: Mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may reduce the efficacy of neutralizing monoclonal antibody therapy against coronavirus disease 2019 (COVID-19). We here evaluated the efficacy of casirivimab-imdevimab in patients with mild-to-moderate COVID-19 during the Delta variant surge in Fukushima Prefecture, Japan. Methods: We enrolled 949 patients with mild-to-moderate COVID-19 who were admitted to hospital between July 24, 2021 and September 30, 2021. Clinical deterioration after admission was compared between casirivimab-imdevimab users (n = 314) and non-users (n = 635). Results: The casirivimab-imdevimab users were older (P < 0.0001), had higher body temperature (≥ 38°C) (P < 0.0001) and greater rates of history of cigarette smoking (P = 0.0068), hypertension (P = 0.0004), obesity (P < 0.0001), and dyslipidemia (P < 0.0001) than the non-users. Multivariate logistic regression analysis demonstrated that receiving casirivimab-imdevimab was an independent factor for Ivyspring International Publisher preventing deterioration (odds ratio 0.448; 95% confidence interval 0.263-0.763; P = 0.0023). Furthermore, in 222 patients who were selected from each group after matching on the propensity score, deterioration was significantly lower among those receiving casirivimab-imdevimab compared to those not receiving casirivimab-imdevimab (7.66% vs 14.0%; p = 0.021). Conclusion:This real-world study demonstrates that casirivimab-imdevimab contributes to the prevention of deterioration in COVID-19 patients after hospitalization during a Delta variant surge.

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

“…Overall, mAb therapies can effectively reduce the hospitalisation rate caused by COVID-19 disease. 7,9,[44][45][46][47][48] Moreover, a significantly lower rate of hospitalisation or death was observed among sotrovimab-receiving patients. Note that this finding should be interpreted with caution due to a high degree of heterogeneity between studies.…”

“…In agreement with our results, a recently published meta‐analysis 43 showed that sotrovimab may reduce the hospitalisation rate in patients with non‐severe COVID‐19. Overall, mAb therapies can effectively reduce the hospitalisation rate caused by COVID‐19 disease 7,9,44–48 . Moreover, a significantly lower rate of hospitalisation or death was observed among sotrovimab‐receiving patients.…”

“…The current evidence shows the effectiveness of monoclonal antibody (mAb) therapy in the prevention and treatment of COVID‐19 4 . Several anti‐severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) mAb therapies, such as casirivimab/imdevimab, 5–7 bamlanivimab, 8 bamlanivimab/etesevimab, 9–11 and sotrovimab 4,12 have been proposed as promising potential treatments for patients with COVID‐19. Their antiviral activities have been shown by binding and neutralising SARS‐CoV‐2 13 .…”

Clinical effect of early administration of tocilizumab following the initiation of corticosteroid therapy for patients with COVID-19

“…Assessment of COVID-19 severity was performed according to the definition issued by the Japanese Ministry of Health, Labor and Welfare: mild, patients without pneumonia or respiratory failure; moderate-1, patients with pneumonia but without respiratory failure; moderate-2, patients with pneumonia and respiratory failure (percutaneous oxygen saturation < 94% on room air) but do not require mechanical ventilation/extracorporeal membrane oxygenation (ECMO); or severe, patients with pneumonia and respiratory failure who require mechanical ventilation/ECMO [ 9 ]. The need for informed consent was waived because the study is retrospective.…”

Casirivimab-imdevimab treatment is associated with reduced rates of mortality and hospitalization in patients with COVID-19: A systematic review with meta-analysis

“…Through a thorough literature search, a total of nine studies, including 84875 in the casirivimab-imdevimab group and 322,943 in the control group arm, were identified for this meta-analysis. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 Table 1 lists the illness features and demographics of the 407818 patients who were included in the pooled study. The majority of the included studies were from the United States.…”