The effect of casirivimab with imdevimab on disease progression in nonsevere COVID‐19 patients in a single hospital in Japan
MD | Junpei Komagamine, MD | Taku Yabuki, MD Satsuki Yoshihara, MD Nao Tanaka
Journal of General and Family Medicine, doi:10.1002/jgf2.516
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.
References
Charlson, Pompei, Ales, Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis
Cohen, Nirula, Mulligan, Novak, Marovich et al., Effect of bamlanivimab vs placebo on incidence of COVID-19 among residents and staff of skilled nursing and assisted living facilities: a randomized controlled trial, JAMA
Dagan, Barda, Keptan, Miron, Perchik et al., BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting, N Engl J Med
Dougan, Nirula, Azizad, Mocherla, Gottlieb et al., Bamlanivimab plus etesevimab in mild or moderate covid-19, N Engl J Med
Gupta, Gonzalez-Rojas, Juarez, Casal, Moya et al., Early treatment for Covid-19 with SARS-CoV-2 neutralizing antibody sotrovimab, N Engl J Med,
doi:10.1101/2021.05.27.21257096Matsunaga, Hayakawa, Terada, Ohtsu, Asai et al., Clinical epidemiology of hospitalized patients with COVID-19 in Japan: report of the COVID-19 Registry Japan, Clin Infect Dis,
doi:10.1093/cid/ciaa1470O'brien, Forleo-Neto, Musser, Chan, Sarkar, Subcutaneous REGEN-COV antibody combination to prevent covid-19, N Engl J Med
Peduzzi, Concato, Kemper, Holford, Feinstein, A simulation study of the number of events per variable in logistic regression analysis, J Clin Epidemiol
Pharmaceuticals, Devices, RONAPREVE for intravenous infusion set 300/ RONAPREVE for intravenous infusion set 1332
Roth, Emmons-Bell, Alger, Bradley, Das et al., Trends in patient characteristics and COVID-19 in-hospital mortality in the United States during the COVID-19 pandemic, JAMA Network Open
Siemieniuk, Bartoszko, Ge, Zeraatkar, Izcovich et al., Drug treatments for covid-19: living systematic review and network meta-analysis, BMJ
Taylor, Adams, Hufford, De La Torre, Winthrop et al., Neutralizing monoclonal antibodies for treatment of COVID-19, Nat Rev Immunol
Tian, Jiang, Tao, Nicholson, Li et al., Predictor of mortality in hospitalized COVID-19 patients: A systematic review and meta-analysis, J Med Virol
Weinreich, Sivapalasingam, Norton, Ali, Gao et al., REGEN-COV antibody combination and outcomes in outpatients with covid-19, N Engl J Med,
doi:10.1056/NEJMoa2108163Zhu, Zhang, Li, Yang, Song, A novel coronavirus from patients with pneumonia in China, 2019, N Engl J Med
