The effect of casirivimab with imdevimab on disease progression in nonsevere COVID-19 patients in a single hospital in Japan
Komagamine et al.,
The effect of casirivimab with imdevimab on disease progression in nonsevere COVID-19 patients in a single..,
Journal of General and Family Medicine, doi:10.1002/jgf2.516
Combined retrospective/prospective study in Japan with 53 casirivimab/imdevimab patients and 75 control patients, showing significantly lower progression with treatment.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for omicron [Liu, Sheward, Tatham, VanBlargan].
risk of mechanical ventilation, 77.3% lower, RR 0.23, p = 0.51, treatment 0 of 53 (0.0%), control 2 of 75 (2.7%), NNT 38, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
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risk of ICU admission, 92.3% lower, RR 0.08, p = 0.04, treatment 0 of 53 (0.0%), control 7 of 75 (9.3%), NNT 11, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
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risk of progression, 67.8% lower, RR 0.32, p = 0.006, treatment 8 of 53 (15.1%), control 33 of 75 (44.0%), NNT 3.5, adjusted per study, odds ratio converted to relative risk, multivariable, primary outcome.
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hospitalization time, 28.9% lower, relative time 0.71, p < 0.001, treatment 53, control 75.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Komagamine et al., 19 Dec 2021, retrospective, Japan, peer-reviewed, 4 authors, average treatment delay 5.0 days.
Abstract: Received: 21 October 2021
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Revised: 7 December 2021
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Accepted: 9 December 2021
DOI: 10.1002/jgf2.516
ORIGINAL ARTICLE
The effect of casirivimab with imdevimab on disease
progression in nonsevere COVID-19 patients in a single
hospital in Japan
Junpei Komagamine MD
Department of Internal Medicine, National
Hospital Organization Tochigi Medical
Center, Utsunomiya, Japan
Correspondence
Junpei Komagamine, Department of
Internal Medicine, National Hospital
Organization Tochigi Medical Center,
1-10-37, Nakatomatsuri, Utsunomiya,
Tochigi, Japan.
Email: junpei0919@yahoo.co.jp
| Taku Yabuki MD | Satsuki Yoshihara MD | Nao Tanaka MD
Abstract
Background: Recent randomized trials have revealed that neutralizing monoclonal
antibodies can reduce disease progression in mild–moderate COVID-19 patients.
However, no studies have investigated the effect of neutralizing monoclonal antibodies on clinical outcomes in Japan.
Methods: A single-center retrospective and prospective cohort study was conducted.
All consecutive febrile nonsevere COVID-19 patients with at least one risk factor
were included. The primary outcome was progression to severe COVID-19. Severe
COVID-19 cases were defined as patients requiring oxygen therapy and dexamethasone. The differences in the primary outcomes between the patients who were
treated with casirivimab with imdevimab (treatment group) and those who were not
(control group) were compared using the chi-squared test.
Results: A total of 128 patients were included. Of those, the mean age was 53.6 years
old (SD 9.9), and 52 (40.6%) were women. Fifty-three patients were treated with casirivimab with imdevimab, and 75 patients were given the standard treatment only.
The primary outcome occurred in eight (15.1%) of the 53 patients in the treatment
group and 33 (44.0%) of the 75 patients in the control group (odd ratio [OR] 0.23,
95% CI 0.09 to 0.55). The multivariate analysis revealed that the use of casirivimab
with imdevimab (OR 0.21, 95% CI 0.08 to 0.54) was the only independent risk factor
associated with progression to severe COVID-19. No patients died during hospitalization in either group.
Conclusion: Similar to other countries, casirivimab with imdevimab significantly reduced disease progression in early nonsevere COVID-19 patients with fever and risk
factors in Japan.
KEYWORDS
casirivimab, COVID-19, imdevimab
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,
provided the original work is properly cited.
© 2021 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association.
J Gen Fam Med. 2021;00:1–6.
wileyonlinelibrary.com/journal/jgf2
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I NTRO D U C TI O N
the institutional Medical Ethics Committee because we collected
de-identified data without contacting the patients. However, per
Since the first case of severe acute respiratory syndrome coronavi-
the Japanese Ethical Guidelines, we displayed an opt-o ut state-
rus 2 (SARS-CoV-2) was documented in December 2019 in China,1
ment in the waiting room and on the webpage of the hospital to
several treatments for coronavirus disease 2019 (COVID-19) have
inform patients about the study and to provide the opportunity
been developed. Dexamethasone and interleukin (IL)-6 receptor
for patients to decline the use of..
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