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0 0.5 1 1.5 2+ Further treatment includin.. 58% Improvement Relative Risk Casirivimab/i..  Kakinoki et al.  EARLY TREATMENT Is early treatment with casirivimab/imdevimab beneficial for COVID-19? Retrospective 108 patients in Japan Lower progression with casirivimab/imdevimab (p=0.049) c19early.org Kakinoki et al., Int. J. Infectious Di.., Nov 2021 Favors casirivimab/im.. Favors control

Impact of Antibody Cocktail Therapy Combined with Casirivimab and Imdevimab on Clinical Outcome for Covid-19 patients in A Real-Life Setting: A Single Institute Analysis

Kakinoki et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.01.067 (date from preprint)
Nov 2021  
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16th treatment shown to reduce risk in March 2021
 
*, now known with p = 0.000018 from 28 studies, recognized in 42 countries. Efficacy is variant dependent.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments. c19early.org
Retrospective 55 patients in Japan treated a median of 3 days from symptom onset with casirivimab/imdevimab, and 53 control patients, showing lower risk of further treatment including oxygen or antivirals.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants Haars, Liu, Pochtovyi, Sheward, Tatham, VanBlargan.
risk of further treatment including oxygen or antivirals, 57.6% lower, RR 0.42, p = 0.049, treatment 13 of 55 (23.6%), control 22 of 53 (41.5%), NNT 5.6, adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kakinoki et al., 4 Nov 2021, retrospective, Japan, peer-reviewed, 16 authors, average treatment delay 3.0 days.
This PaperCasirivimab/i..All
Impact of Antibody Cocktail Therapy Combined with Casirivimab and Imdevimab on Clinical Outcome for patients with COVID-19 in A Real-Life Setting: A Single Institute Analysis
MD, PhD1 Yasutaka Kakinoki, MD Kazuki Yamada, MD Yoko Tanino, MD Keiko Suzuki, MD Takaya Ichikawa, MD Naoki Suzuki, Go Asari, MD Ai Nakamura, MD Shin Kukita, MD Akito Uehara, MD Seisuke Saito, MD Shohei Kuroda, MD Hidemitsu Sakagami, MD Yuuki Nagashima, MD Kae Takahashi, MD Satoshi Suzuki
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.01.067
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.
AUTHOR CONTRIBUTIONS: Design of research studies: YK and KY. Data acquisition: TK, KY, GA, and NS. Data analysis: YK and KY. Writing the manuscript: YK. All authors worked hard to take care of patients with Covid-19.
References
Baum, Fulton, Wloga, Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies, Science
Copin, Baum, Wloga, The monoclonal antibody combination REGEN-COV protects against SARS-C0V-2 mutational escape in preclinical and human studies, Cell
Hansen, Baum, Pascal, Studies in humanized mice and convalescent humans yield a SARS-CoV-2 antibody cocktail, Science
Ikemura, Hoshino, Higuchi, SARS-CoV-2 Omicron variant escapes neutralization by vaccinated and convalescent sera and therapeutic monoclonal antibodies, doi:10.1101/2021.12.13.21267761
Kanda, Investigation of the freely-available easy-to-use software"EZR" (Easy R) for medical statistics, Bone Marrow Transplant, doi:10.1038/bmt.2012.244
Wang, Nair, Liu, Antibody resistance of SARS-CoV-2 variants B.1.351 and B.1.1.7, Nature
Weinreich, Sivapalasingam, Norton, REGEN-COV antibody cocktail clinical outcomes study in Covid-19 outpatients, doi:10.1101/2021.05.19.21257469v2
Weinreich, Sivapalasingam, Norton, REGN-COV2, a neutralizing antibody cocktail, in outpatients with Covid-19, N Engl J Med
Welfare, Brien, Forleo-Neto, Musser, Approval for Ronapreve TM (casirivimab and imdevimab) for the treatment of patients with mild to moderate Covid-19, N Engl J Med
Wilhelm, Widera, Grikscheit, Reduced neutralization of SARS-CoV-2 omicron variant by vaccine sera and monoclonal antibodies, doi:10.1101/2021.12.07.21267432
Wu, Zhao, Yu, A new coronavirus associated with human respiratory disease in China, Nature
Zhu, Zhang, Wang, A novel coronavirus from patients with pneumonia in China, 2019, N Engl J Med
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