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Real-world evidence of sotrovimab effectiveness for preventing severe outcomes in patients with COVID-19: A quality improvement propensity matched retrospective cohort study of a pan-provincial program in Alberta, Canada

Farmer et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2024.107136
Jun 2024  
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Death/hospitalization -20% Improvement Relative Risk Sotrovimab  Farmer et al.  EARLY TREATMENT Is early treatment with sotrovimab beneficial for COVID-19? PSM retrospective 22,289 patients in Canada (Dec 2021 - Apr 2022) Higher death/hosp. with sotrovimab (not stat. sig., p=0.2) c19early.org Farmer et al., Int. J. Infectious Dise.., Jun 2024 Favorssotrovimab Favorscontrol 0 0.5 1 1.5 2+
Sotrovimab for COVID-19
41st treatment shown to reduce risk in May 2023, now with p = 0.002 from 25 studies, recognized in 38 countries. Efficacy is variant dependent.
Lower risk for mortality, ICU admission, and hospitalization.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
Retrospective propensity-matched study of 22,289 high-risk COVID-19 outpatients in Canada, showing no significant difference in combined hospitalization/mortality with sotrovimab treatment. In a subgroup analysis of patients with no comorbidities, sotrovimab was associated with lower odds of severe outcomes. The study period included Omicron BA.1 and BA.2 variants, which may have contributed to the reduced efficacy compared to earlier studies.
Efficacy is variant dependent. In Vitro studies predict lower efficacy for BA.11-3, BA.4, BA.54, XBB.1.9.3, XBB.1.5.24, XBB.2.9, CH.1.15, and no efficacy for BA.26, XBB, XBB.1.5, ХВВ.1.9.17, XBB.1.16, BQ.1.1.45, and CL.15. US EUA has been revoked.
risk of death/hospitalization, 20.0% higher, OR 1.20, p = 0.20, treatment 1,603, control 6,299, adjusted per study, propensity score matching, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Farmer et al., 19 Jun 2024, retrospective, Canada, peer-reviewed, 14 authors, study period 15 December, 2021 - 30 April, 2022. Contact: gregory.farmer@albertahealthservices.ca.
This PaperSotrovimabAll
Abstract: Journal Pre-proof Real-world evidence of sotrovimab effectiveness for preventing severe outcomes in patients with COVID-19: A quality improvement propensity matched retrospective cohort study of a pan-provincial program in Alberta, Canada Gregory Farmer , Khokan C. Sikdar , TKT Lo , John Conly , Jeremy Slobodan , Jordan Ross , Samantha James , Hussain Usman , Kyle Kemp , Kristi Baker , Karen Doucette , Cheri Nijssen-Jordan , Lynora M. Saxinger , A. Mark Joffe PII: DOI: Reference: S1201-9712(24)00207-8 https://doi.org/10.1016/j.ijid.2024.107136 IJID 107136 To appear in: International Journal of Infectious Diseases Received date: Revised date: Accepted date: 11 January 2024 21 May 2024 11 June 2024 Please cite this article as: Gregory Farmer , Khokan C. Sikdar , TKT Lo , John Conly , Jeremy Slobodan , Jordan Ross , Samantha James , Hussain Usman , Kyle Kemp , Kristi Baker , Karen Doucette , Cheri Nijssen-Jordan , Lynora M. Saxinger , A. Mark Joffe , Real-world evidence of sotrovimab effectiveness for preventing severe outcomes in patients with COVID19: A quality improvement propensity matched retrospective cohort study of a pan-provincial program in Alberta, Canada, International Journal of Infectious Diseases (2024), doi: https://doi.org/10.1016/j.ijid.2024.107136 This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2024 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Highlights:  Post-marketing surveillance of sotrovimab in Canada is limited.  Sotrovimab was not associated with improved outcomes.  Study results were consistent across different analytic methodologies.  Study findings need to be confirmed in other Canadian provinces. Sotrovimab effectiveness Title: Real-world evidence of sotrovimab effectiveness for preventing severe outcomes in patients with COVID-19: A quality improvement propensity matched retrospective cohort study of a pan-provincial program in Alberta, Canada Authors: Gregory Farmer, MSc1; Khokan C. Sikdar, PhD1,5; TKT Lo, PhD1; John Conly, MD, DSc2,8; Jeremy Slobodan, BSP3; Jordan Ross, MPH1; Samantha James, MPH1; Hussain Usman, M.B.B.S, MSc, Dr.PH1; Kyle Kemp, PhD1; Kristi Baker, PhD4; Karen Doucette, MD, MSc6,8; Cheri Nijssen-Jordan, MD, MBA7; Lynora, M. Saxinger, MD6,8; A. Mark Joffe, MD6,8. Author affiliations: 1Department of Provincial Population and Public Health (PPPH), Alberta Health Services, Edmonton, Canada; 2 Department of Medicine, Division of Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Canada; 3Department of Drug Utilization, Information and Stewardship, Alberta Health Services, Edmonton, Canada; 4 Department of Oncology, Division of Experimental Oncology, University of Alberta, Edmonton, Canada; 5Department of Community Health Sciences, Cumming School of Medicine, University of..
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