Real-World Evaluation of Bebtelovimab Effectiveness During the Period of COVID-19 Omicron Variants including BA.4/BA.5

Molina et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2023.04.396

Apr 2023

Retrospective 3,739 patients treated with bebteloviman in the USA and matched controls, showing lower mortality and hospitalization with treatment, but higher emergency department visits.

Confounding by treatment propensity. This study analyzes a population where only a fraction of eligible patients received the treatment. Patients receiving treatment may be more likely to follow other recommendations, more likely to receive additional care, and more likely to use additional treatments that are not tracked in the data (e.g., nasal/oral hygiene c19early.org, c19early.org (B), vitamin D c19early.org (C), etc.) — either because the physician recommending bebtelovimab also recommended them, or because the patient seeking out bebtelovimab is more likely to be familiar with the efficacy of additional treatments and more likely to take the time to use them. Therefore, these kind of studies may overestimate the efficacy of treatments.

Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for omicron BQ.1.1 Planas, BA.5, BA.2.75, XBB Haars.

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risk of death, 57.0% lower, RR 0.43, p = 0.14, treatment 3 of 3,739 (0.1%), control 11 of 5,423 (0.2%), NNT 816, adjusted per study, odds ratio converted to relative risk, propensity score matching, multivariable.

risk of ICU admission, 58.6% lower, RR 0.41, p = 0.05, treatment 6 of 3,739 (0.2%), control 21 of 5,423 (0.4%), NNT 441.

risk of hospitalization, 55.5% lower, RR 0.44, p < 0.001, treatment 38 of 3,739 (1.0%), control 107 of 5,423 (2.0%), NNT 105, adjusted per study, odds ratio converted to relative risk, COVID-19, propensity score matching, multivariable.

risk of hospitalization, 46.5% lower, RR 0.54, p < 0.001, treatment 48 of 3,739 (1.3%), control 116 of 5,423 (2.1%), NNT 117, adjusted per study, odds ratio converted to relative risk, all cause, propensity score matching, multivariable.

risk of progression, 32.6% higher, RR 1.33, p = 0.001, treatment 260 of 3,739 (7.0%), control 275 of 5,423 (5.1%), adjusted per study, odds ratio converted to relative risk, ED visit, propensity score matching, multivariable.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Molina et al., 16 Apr 2023, retrospective, USA, peer-reviewed, 11 authors, study period 6 April, 2022 - 11 October, 2022. Contact: kyle.molina@cuanschutz.edu.

This Paper Bebtelovimab All

Real-World Evaluation of Bebtelovimab Effectiveness During the Period of COVID-19 Omicron Variants including BA.4/BA.5

Pharm.D. Kyle C Molina, MPSH Victoria Kennerley, MS Laurel E Beaty, MD Tellen D Bennett, PhD Nichole E Carlson, PhD David A Mayerij, BSN Jennifer L Peers, MS Seth Russell, MD Matthew K Wynia, MD, MHSc Neil R Aggarwal, MD, MPH Adit A Ginde

International Journal of Infectious Diseases, doi:10.1016/j.ijid.2023.04.396

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 AAG conceived and obtained funding for the study. KCM, VK LEB, NEC, NRA and AAG designed the study. VK, LEB, and NEC analysed the data. VK, LEB, TDB, NEC, DAM, and SR accessed and verified the data. KCM drafted the original version of the manuscript. All authors Conflict of Interest Statement The authors report no conflicts of interest.

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