Bamlanivimab for the Prevention of Hospitalizations and Emergency Department Visits in SARS-CoV-2–Positive Patients in a Regional Health Care System
Priest et al.,
Bamlanivimab for the Prevention of Hospitalizations and Emergency Department Visits in SARS-CoV-2–Positive..,
Infectious Diseases in Clinical Practice, doi:10.1097/IPC.0000000000001130
Retrospective 379 bamlanivimab patients and 379 matched controls in the USA, showing no significant differences with treatment.
Efficacy is highly variant dependent. In Vitro research suggests a lack of efficacy for omicron [Liu, Sheward, VanBlargan].
risk of death, no change, RR 1.00, p = 1.00, treatment 6 of 379 (1.6%), control 6 of 379 (1.6%).
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risk of hospitalization, 3.9% higher, RR 1.04, p = 0.86, treatment 79 of 379 (20.8%), control 76 of 379 (20.1%), all-cause hospital revisit.
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risk of hospitalization/ER, 5.0% higher, OR 1.05, p = 0.86, treatment 379, control 379, RR approximated with OR.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Priest et al., 27 Jan 2022, retrospective, propensity score matching, USA, peer-reviewed, 5 authors, study period October 2020 - March 2021, average treatment delay 6.0 days.
Abstract: ORIGINAL ARTICLE
Bamlanivimab for the Prevention of Hospitalizations and
Emergency Department Visits in SARS-CoV-2–Positive
Patients in a Regional Health Care System
David H. Priest, MD, MPH,* Lisa M. Blanchette, PharmD, MHA,† Aliza L. Hekman, MMS, PA-C,*
Rahul Maddikunta, MS,* and Paula E. Burleson, BSBA*
Introduction: Bamlanivimab (LY-CoV555) was approved by Emergency
Use Authorization by the United States Food and Drug Administration in the
ambulatory setting to prevent hospitalizations and emergency department
visits. We report a retrospective, case-control study of bamlanivimab use in
a regional health care system.
Methods: A retrospective case-control study for SARS-CoV-2–positive
patients receiving bamlanivimab and matched controls between October
2020 and March 2021 was performed. End points included all-cause hospitalization, emergency department visits, and mortality.
Results: No statistically significant difference was noted in all-cause hospitalization, emergency department visits, or mortality, including patients
65 years or older, body mass index of 35 or higher, diagnosis of diabetes
mellitus, or cancer (high-risk patients). No difference was seen based on
timing of bamlanivimab infusion relative to symptom onset or timing of infusion within the study period.
Conclusions: Based on the evaluated endpoints, there was no benefit from
bamlanivimab, regardless of when it was received in a patient's clinical
course or when during the study period it was received. A lack of efficacy
of monoclonal antibodies in patients infected with COVID-19 variants has
been noted, but the impact of local variants on these results could not be
assessed given a lack of available variant diagnostic tools. These findings
do not support bamlanivimab for the prevention of hospitalization or emergency department visits for patients with mild to moderate SARS-CoV2 infection.
Key Words: SARS-CoV-2, COVID-19, bamlanivimab, monoclonal
antibody
(Infect Dis Clin Pract 2022;30: e1130)
T
he COVID-19 pandemic caused by SARS-CoV-2 has had a
devastating impact on the health of communities around the
world, as well as the global economy.1,2 In response, several therapeutic interventions have been developed and evaluated, including virus neutralizing monoclonal antibodies.3,4 These antibodies
are isolated from the blood of recovered patients after infection
with SARS-CoV-2 and offer passive immunity to those receiving
the antibody therapies. One such agent is bamlanivimab (LYCoV555; Lilly), a recombinant, neutralizing monoclonal antibody developed by the US Vaccine Research Center at the National Institute of Allergy and Infectious Diseases and AbCellera
From the *Novant Health Institute of Safety and Quality; †Novant Health Department of Pharmacy, Winston-Salem, NC.
Correspondence to: David H. Priest, MD, MPH, Novant Health Institute of
Safety and Quality, Suite 600, 101 North Cherry St, Winston-Salem, NC
27101. E‐mail: dhpriest@novanthealth.org.
The authors have no funding or conflicts of interest to disclose.
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
This is an open-access article distributed under the terms of the Creative
Commons Attribution-Non Commercial-No Derivatives License 4.0
(CCBY-NC-ND), where it is permissible to download and share the..
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