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0 0.5 1 1.5 2+ Mortality 45% unadjusted Improvement Relative Risk ICU admission 58% unadjusted Hospitalization 5% primary, unadjusted Mortality (b) -17% unadjusted ICU admission (b) 9% unadjusted Hospitalization (b) 28% unadjusted Bamlanivimab/e..  Cooper et al.  EARLY TREATMENT Is early treatment with bamlanivimab/etesevimab beneficial for COVID-19? Retrospective 10,961 patients in the USA Lower ICU admission with bamlanivimab/etesevimab (not stat. sig., p=0.33) Cooper et al., Open Forum Infectious D.., Oct 2021 Favors bamlanivimab/e.. Favors control

Real-world Assessment of 2,879 COVID-19 Patients Treated with Monoclonal Antibody Therapy: A Propensity Score-Matched Cohort Study

Cooper et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab512
Oct 2021  
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Retrospective 2,879 patients and matched controls in the USA, showing significantly lower mortality and hospitalization with bamlanivimab, bamlanivimab/etesevimab, and casirivimab/imdevimab. There was significantly lower hospitalization with casirivimab/imdevimab compared to bamlanivimab or bamlanivimab/etesevimab. PSM and multivariate analysis is only provided for all treatments combined.
Efficacy is highly variant dependent. In Vitro research suggests a lack of efficacy for omicron Liu, Sheward, VanBlargan. This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
This study includes casirivimab/imdevimab and bamlanivimab/etesevimab.
risk of death, 45.3% lower, RR 0.55, p = 1.00, treatment 1 of 473 (0.2%), control 33 of 8,534 (0.4%), NNT 571, unadjusted, bamlanivimab-etesevimab.
risk of ICU admission, 57.5% lower, RR 0.42, p = 0.33, treatment 2 of 473 (0.4%), control 85 of 8,534 (1.0%), NNT 174, unadjusted, bamlanivimab-etesevimab.
risk of hospitalization, 5.0% lower, RR 0.95, p = 0.86, treatment 37 of 473 (7.8%), control 703 of 8,534 (8.2%), NNT 241, unadjusted, bamlanivimab-etesevimab, primary outcome.
risk of death, 17.2% higher, RR 1.17, p = 0.59, treatment 11 of 2,427 (0.5%), control 33 of 8,534 (0.4%), unadjusted, bamlanivimab.
risk of ICU admission, 9.0% lower, RR 0.91, p = 0.81, treatment 22 of 2,427 (0.9%), control 85 of 8,534 (1.0%), NNT 1117, unadjusted, bamlanivimab.
risk of hospitalization, 28.0% lower, RR 0.72, p < 0.001, treatment 144 of 2,427 (5.9%), control 703 of 8,534 (8.2%), NNT 43, unadjusted, bamlanivimab.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cooper et al., 8 Oct 2021, retrospective, USA, peer-reviewed, 9 authors.
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Real-world Assessment of 2,879 COVID-19 Patients Treated with Monoclonal Antibody Therapy: A Propensity Score-Matched Cohort Study
PharmD Megan H Cooper, Paul A Christensen, Eric Salazar, Katherine K Perez, Edward A Graviss, Duc Nguyen, James M Musser, Howard J Huang, Michael G Liebl
We assessed the outcomes of 2,879 SARS-CoV-2-positive patients transfused with one of three available monoclonal antibody (mAbs) treatments compared to a propensity-matched control cohort. We found that administration of mAbs significantly reduced 28-day hospitalizations and mortality.
A c c e p t e d M a n u s c r i p t 14 Monoclonal antibodies are susceptible to the evolution of viral resistance mutations in target epitopes, and the EUA for bamlanivimab was revoked due to demonstrated resistance of emerging variants ( Similarly, the EUA for bamlanivimab and etesevimab was recently revoked (June 25, 2021), due to the increasing prevalence of the P.1 and B.1.351 variants ( that have been shown to escape certain mAbs. 23, 26 Combination mAbs that bind non-overlapping epitopes reduce the risk of resistance and have a clear advantage, and continued monitoring and assessment of emerging variants and their susceptibility to natural or induced immunity and therapeutic antibodies remains crucial. In summary, our propensity score-matched analysis confirms that early infusion of neutralizing mAbs to COVID-19 patients significantly reduced hospitalization and mortality among a large cohort of high-risk individuals. These data support continued widespread efforts to make early passive immune therapy available to COVID-19 patients. Potential Conflicts of Interest All authors report no conflicts of interest related to this study. A c c e p t e d M a n u s c r i p t 15 The study was reviewed and approved by the Houston Methodist Research Institute Institutional Review Board (IRB PRO00029666). Given the study design, patient's written consent was not required. However, verbal and written..
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