COVID-19 treatment: monoclonal antibodies

• Monoclonal antibodies are effective for matching variants, but were rarely used

@CovidAnalysis, January 10, 2026, Version 27V27
c19early.org
Efficacy confidence - mAbs
Casirivimab/imdevimabp=0.0001
Bamlanivimab/etesevimabp=0.0005
Regdanvimabp=0.0005
Sotrovimabp=0.0005
Tixagevimab/cilgavimabp=0.007
mAbs show high variant dependence—may not be effective for recent variants.

P-values indicate the confidence that studies show a significant effect. p=0.05 is the typical threshold for significance, with lower values indicating higher confidence. See the individual analyses for details of efficacy for specific outcomes and conditions.
Monoclonal antibodies (mAbs) Many mAbs have shown efficacy, including casirivimab/imdevimab, bamlanivimab/etesevimab, tixagevimab/cilgavimab, sotrovimab, and regdanvimab1-119, however they are highly variant dependent and may have limited or no efficacy with more recent variants. They also require intravenous, subcutaneous, or intramuscular administration, limiting easy and immediate access, have been linked to the creation of new variants120-122, and may increase risk with the potential for emergence of resistant mutations during treatment123,124. Although highly effective for the appropriate variants, mAbs were rarely used125.
Protocols combine multiple treatments No single treatment is guaranteed to be effective and safe for a specific individual. Leading evidence-based protocols combine multiple treatments.
c19early.org
Combined treatments increase efficacy
Monotherapy29% [26‑32%]
Polytherapy65% [54‑74%]
 Meta-analysis of early treatment studies.
Complementary/synergistic actions, viral evolution, escape risk suggest polytherapy There are many complementary mechanisms of action, and studies show complementary and synergistic effects with polytherapy129-145. For example, Jitobaom et al.130 shows >10x reduction in IC50 with ivermectin and niclosamide, an RCT by Said et al.137 showed the combination of nigella sativa and vitamin D was more effective than either alone, and an RCT by Wannigama et al.146 showed improved results with fluvoxamine combined with additional treatments, compared to fluvoxamine alone.
SARS-CoV-2 can rapidly acquire mutations altering infectivity, disease severity, and drug resistance even without selective pressure147-154. Antigenic drift can undermine more variant-specific treatments like monoclonal antibodies and more specific antivirals. Treatment with targeted antivirals may select for escape mutations155. The efficacy of treatments varies depending on cell type156 due to differences in viral receptor expression, drug distribution and metabolism, and cell-specific mechanisms. Efficacy may also vary based on genetic variants157-167.
Variable efficacy across variants, cell types, tissues, and host genetics, along with the complementary and synergistic actions of different treatments, all point to greater efficacy with polytherapy. In many studies, the standard of care given to all patients includes other treatments—efficacy seen in these trials may rely in part on synergistic effects. Less variant specific treatments and polytherapy targeting multiple viral and host proteins may be more effective. Meta-analysis of all early treatment trials shows 65% [54‑74%] lower risk for studies using combined treatments, compared to 29% [26‑32%] for single treatments.
Contact.
Contact us on X at @CovidAnalysis.
Funding.
We have received no funding or compensation in any form, and do not accept donations. This is entirely volunteer work.
Conflicts of interest.
We have no conflicts of interest. We have no affiliation with any pharmaceutical companies, supplement companies, governments, political parties, or advocacy organizations.
AI.
We use AI models (Gemini, Grok, Claude, and ChatGPT) tasked with functioning as additional peer-reviewers to check for errors, suggest improvements, and review spelling and grammar. Any corrections are verified and applied manually. Our preference for em dashes is independent of AI.
Dedication.
This work is dedicated to those who risked their career to save lives under extreme censorship and persecution from authorities and media that have not even reviewed most of the science. In alphabetical order, those that paid the ultimate price: Dr. Thomas J. Borody, Dr. Jackie Stone, Dr. Vladimir (Zev) Zelenko; and those that continue to risk their careers to save lives: Dr. Mary Talley Bowden, Dr. Flavio Cadegiani, Dr. Shankara Chetty, Dr. Ryan Cole, Dr. George Fareed, Dr. Sabine Hazan, Dr. Pierre Kory, Dr. Tess Lawrie, Dr. Robert Malone, Dr. Paul Marik, Dr. Peter McCullough, Dr. Didier Raoult, Dr. Harvey Risch, Dr. Brian Tyson, Dr. Joseph Varon, and the estimated over one million physicians worldwide that prescribed one or more low-cost COVID-19 treatments known to reduce risk, contrary to authority beliefs.
Public domain.
This is a public domain work distributed in accordance with the Creative Commons CC0 1.0 Universal license, which dedicates the work to the public domain by waiving all rights worldwide under copyright law. You can distribute, remix, adapt, and build upon this work in any medium or format, including for commercial purposes, without asking permission. Referenced material and third-party images retain any original copyrights or restrictions. See: https://creativecommons.org/publicdomain/zero/1.0/.
 
References