Clinical efficacy of casirivimab-imdevimab antibody combination treatment in patients with COVID-19 Delta variant

Miyashita et al., Journal of Infection and Chemotherapy, doi:10.1016/j.jiac.2022.05.012, May 2022
Ventilation 33% improvement lower risk ← → higher risk Oxygen therapy 46% Casirivimab/i..  Miyashita et al.  EARLY TREATMENT Is early treatment with casirivimab/imdevimab beneficial for COVID-19? Retrospective 922 patients in Japan Lower need for oxygen therapy with treatment (p=0.0044) c19early.org Miyashita et al., J. Infection and Che.., May 2022 0 0.5 1 1.5 2+ RR
18th treatment shown to reduce risk in March 2021, now with p = 0.000095 from 34 studies, recognized in 52 countries. Efficacy is variant dependent.
Lower risk for hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,200+ studies for 200+ treatments. c19early.org
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Retrospective 461 patients treated with casirivimab/imdevimab in Japan, and 461 matched controls, showing lower oxygen requirements with treatment.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants1-7.
Standard of Care (SOC) for COVID-19 in the study country, Japan, is very poor with very low average efficacy for approved treatments8. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
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risk of mechanical ventilation, 33.3% lower, RR 0.67, p = 1.00, treatment 2 of 461 (0.4%), control 3 of 461 (0.7%), NNT 461.
risk of oxygen therapy, 46.4% lower, RR 0.54, p = 0.004, treatment 30 of 461 (6.5%), control 56 of 461 (12.1%), NNT 18.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Miyashita et al., 26 May 2022, retrospective, Japan, peer-reviewed, 6 authors, average treatment delay 4.0 days.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 Japan United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR Japan favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 Japan United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria Japan favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
Clinical efficacy of casirivimab-imdevimab antibody combination treatment in patients with COVID-19 Delta variant
MD Naoyuki Miyashita, Yasushi Nakamori, Makoto Ogata, Naoki Fukuda, Akihisa Yamura, Yoshihisa Ishiura
Journal of Infection and Chemotherapy, doi:10.1016/j.jiac.2022.05.012
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Conflicts of interest The authors declare that they have no conflicts of interest. Author's contributions: All the authors conceived the study, participated in its design and coordination and collected and managed the data, including quality control. NM and YN drafted the manuscript, and all authors contributed substantially to its revision. All the authors read and approved the final manuscript. Ethical approval and consent to participate J o u r n a l P r e -p r o o f
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