Evaluating the use of Monoclonal Antibodies - Sotrovimab, Casirivimab/Imedvimab (REGEN-COV) and Tixagevimab/Cilgavimab (EVUSHELD) for COVID-19 Treatment in Singapore
PSM retrospective 366 hospitalized COVID-19 patients in Singapore showing no statistically significant reduction in severe outcomes with monoclonal antibodies (mAbs), except for lower oxygen use in patients treated with sotrovimab during the Omicron wave. The 2021 numbers for sotrovimab do not appear to be reported correctly, for example showing >96% intubation and higher incidence of ICU admission than the composite outcome that includes ICU admission. Multiple numbers appear to have been transposed.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for omicron BA.2.75.2, BA.4.6, BQ.1.11, BA.5, BA.2.75, XBB2,3, XBB.1.53, ХВВ.1.9.13, XBB.1.9.3, XBB.1.5.24, XBB.1.16, XBB.2.9, BQ.1.1.45, CL.1, and CH.1.14.
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risk of mechanical ventilation, 50.0% higher, RR 1.50, p = 0.64, treatment 2 of 83 (2.4%), control 4 of 249 (1.6%), propensity score matching.
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risk of ICU admission, 7.7% lower, RR 0.92, p = 1.00, treatment 4 of 83 (4.8%), control 13 of 249 (5.2%), NNT 249, propensity score matching.
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risk of oxygen therapy, 32.8% lower, RR 0.67, p = 0.17, treatment 13 of 83 (15.7%), control 58 of 249 (23.3%), NNT 13, propensity score matching.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Pochtovyi et al., In Vitro Efficacy of Antivirals and Monoclonal Antibodies against SARS-CoV-2 Omicron Lineages XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1, Vaccines,
doi:10.3390/vaccines11101533.mdpi.com, doi.org.
Chua et al., 29 Jan 2025, retrospective, Singapore, peer-reviewed, 9 authors.
Evaluating the use of Monoclonal Antibodies -Sotrovimab, Casirivimab/ Imedvimab (REGEN-COV) and Tixagevimab/Cilgavimab (EVUSHELD) for COVID-19 Treatment in Singapore
Annabel Chua, Bsc Pharmacy, Puay Hoon, Bachelor of Information Technology Eve Nah, MSc (ID), BCIDP Grace Hoo, PhD Ying Hao, ; Jun, Xin Tay, Barnaby Edward Young, PhD M B Bchir, ; Matthias, MBBS, MMED Paul Toh, MBBS MPH PhD Mark Chen, MBBS, MRCP, D(ABP), D(ABIM) (Inf Dis Shawn Vasoo, Frcpath
Identifying patients at higher risk for developing severe COVID-19-related complications (69%) • Incorporating new information about treatment options for non-hospitalized patients with COVID-19 (67%) • Ensure patients receive treatment within the appropriate therapeutic window (60%) • Educating patients on COVID-19 and available antiviral treatments (58%) • Screening patients for potential DDIs prior to COVID-19 antiviral initiation (55%) • Some of the barriers to implementing these practice changes include: • Patients present outside the recommended treatment window • Unfamiliar with potential drug-drug interactions for COVID-19 antivirals • Patient concerns or questions regarding available antivirals • Unfamiliar with guideline recommendations for available antivirals • Lack of time during office visits to educate patients on the importance of timely testing and treatment
