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All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Hospitalization 25% Improvement Relative Risk Hospitalization, 7000mg.. 52% Hospitalization, 700mg.. -1% Time to symptom impro.. -14% primary Time to symptom i.. (b) -17% primary Progression, 7000mg -1% Progression, 700mg 2% Viral load, 7000mg, day 3 26% Viral load, 700mg, day 3 35% Bamlanivimab/e..  ACTIV-2/A5401  LATE TREATMENT  RCT Is late treatment with bamlanivimab/etesevimab beneficial for COVID-19? RCT 317 patients in the USA (August - November 2020) Improved viral clearance with bamlanivimab/etesevimab (p=0.002) Chew et al., Nature Communications, Aug 2022 Favors bamlanivimab/e.. Favors control

Antiviral and clinical activity of bamlanivimab in a randomized trial of non-hospitalized adults with COVID-19

Chew et al., Nature Communications, doi:10.1038/s41467-022-32551-2, ACTIV-2/A5401, NCT04427501
Aug 2022  
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RCT 317 outpatients in the USA showing faster viral load and inflammatory biomarker decline, but no significant differences in clinical outcomes.
Efficacy is highly variant dependent. In Vitro research suggests a lack of efficacy for omicron Liu, Sheward, VanBlargan.
risk of hospitalization, 25.5% lower, RR 0.75, p = 0.60, treatment 6 of 159 (3.8%), control 8 of 158 (5.1%), NNT 78, combined.
risk of hospitalization, 52.1% lower, RR 0.48, p = 0.43, treatment 2 of 48 (4.2%), control 4 of 46 (8.7%), NNT 22, 7000mg, day 28.
risk of hospitalization, 0.9% higher, RR 1.01, p = 1.00, treatment 4 of 111 (3.6%), control 4 of 112 (3.6%), 700mg, day 28.
relative time to symptom improvement, 13.5% higher, relative time 1.14, p = 0.97, treatment 48, control 46, 7000mg, primary outcome.
relative time to symptom improvement, 17.1% higher, relative time 1.17, p = 0.08, treatment 111, control 112, 700mg, primary outcome.
risk of progression, 0.6% higher, RR 1.01, p = 1.00, treatment 42 of 48 (87.5%), control 40 of 46 (87.0%), at least one symptom more severe than baseline, 7000mg.
risk of progression, 2.0% lower, RR 0.98, p = 0.62, treatment 102 of 111 (91.9%), control 105 of 112 (93.8%), NNT 54, at least one symptom more severe than baseline, 700mg.
viral load, 25.6% lower, relative load 0.74, p = 0.002, treatment 48, control 46, 7000mg, day 3.
viral load, 35.3% lower, relative load 0.65, p = 0.07, treatment 111, control 112, 700mg, day 3.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chew et al., 22 Aug 2022, Randomized Controlled Trial, placebo-controlled, USA, peer-reviewed, 26 authors, study period 19 August, 2020 - 15 November, 2020, average treatment delay 6.0 days, trial NCT04427501 (history) (ACTIV-2/A5401).
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This PaperBamlaniv../e..All
Antiviral and clinical activity of bamlanivimab in a randomized trial of non-hospitalized adults with COVID-19
Kara W Chew, Carlee Moser, Eric S Daar, David A Wohl, Jonathan Z Li, Robert W Coombs, Justin Ritz, Mark Giganti, Arzhang Cyrus Javan, Yijia Li, Manish C Choudhary, Rinki Deo, Carlos Malvestutto, Paul Klekotka, Karen Price, Ajay Nirula, William Fischer, Veenu Bala, Ruy M Ribeiro, Alan S Perelson, Courtney V Fletcher, Joseph J Eron, Judith S Currier, Michael D Hughes, Davey M Smith
Nature Communications, doi:10.1038/s41467-022-32551-2
Anti-SARS-CoV-2 monoclonal antibodies are mainstay COVID-19 therapeutics. Safety, antiviral, and clinical efficacy of bamlanivimab were evaluated in the randomized controlled trial ACTIV-2/A5401. Non-hospitalized adults were randomized 1:1 within 10 days of COVID-19 symptoms to bamlanivimab or blinded-placebo in two dose-cohorts (7000 mg, n = 94; 700 mg, n = 223). No differences in bamlanivimab vs placebo were observed in the primary outcomes: proportion with undetectable nasopharyngeal SARS-CoV-2 RNA at days 3, 7, 14, 21, and 28 (risk ratio = 0.82-1.05 for 7000 mg [p(overall) = 0.88] and 0.81-1.21 for 700 mg [p(overall) = 0.49]), time to symptom improvement (median 21 vs 18.5 days [p = 0.97], 7000 mg; 24 vs 20.5 days [p = 0.08], 700 mg), or grade 3+ adverse events. However, bamlanivimab was associated with lower day 3 nasopharyngeal viral levels and faster reductions in inflammatory markers and viral decay by modeling. This study provides evidence of faster reductions in nasopharyngeal SARS-CoV-2 RNA levels but not shorter symptom durations in non-hospitalized adults with early variants of SARS-CoV-2. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Coronavirus disease 2019 (COVID-19), continues to exert an enormous global public health and economic toll, and in the U.S. case-fatality rates exceed estimates for the 1918 influenza pandemic 1 . Anti-SARS-CoV-2 monoclonal antibody (mAb)-based therapies have shown sufficient clinical efficacy to receive emergency
Author contributions Competing interests Additional information Supplementary information The online version contains supplementary material available at
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Late treatment
is less effective
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