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All Studies   Meta Analysis       

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., Infectious Diseases in Clinical Practice, doi:10.1097/IPC.0000000000001130
Jan 2022  
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Mortality 0% Improvement Relative Risk Hospitalization -4% Hospitalization/ER -5% Bamlanivimab/e..  Priest et al.  LATE TREATMENT Is late treatment with bamlanivimab/etesevimab beneficial for COVID-19? PSM retrospective 758 patients in the USA (October 2020 - March 2021) No significant difference in outcomes seen c19early.org Priest et al., Infectious Diseases in .., Jan 2022 Favorsbamlanivimab/e.. Favorscontrol 0 0.5 1 1.5 2+
22nd treatment shown to reduce risk in May 2021, now with p = 0.00036 from 21 studies, recognized in 7 countries. Efficacy is variant dependent.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
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 omicron1-5.
risk of death, no change, RR 1.00, p = 1.00, treatment 6 of 379 (1.6%), control 6 of 379 (1.6%).
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.
risk of hospitalization/ER, 5.0% higher, OR 1.05, p = 0.86, treatment 379, control 379, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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.
This PaperBamlaniv../e..All
Bamlanivimab for the Prevention of Hospitalizations and Emergency Department Visits in SARS-CoV-2-Positive Patients in a Regional Health Care System
MD, MPH David H Priest, PharmD, MHA Lisa M Blanchette, MMS, PA-C Aliza L Hekman, MS Rahul Maddikunta, BSBA Paula E Burleson
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-CoV-2 infection.
References
Chen, Nirula, Heller, SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19, N Engl J Med, doi:10.1056/NEJMoa2029849
Dhand, Lobo, Wolfe, Bamlanivimab for treatment of COVID-19 in solid organ transplant recipients: early single-center experience, Clin Transpl, doi:10.1111/ctr.14245
Focosi, Maggi, Neutralising antibody escape of SARS-CoV-2 spike protein: risk assessment for antibody-based Covid-19 therapeutics and vaccines, Rev Med Virol, doi:10.1002/rmv.2231
Gottlieb, Nirula, Chen, Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial, JAMA
Kaplon, Reichert, Antibodies to watch in 2021, MAbs, doi:10.1080/19420862.2020.1860476
Liu, Wei, Zhang, V2 and 501Y.V3 variants of SARS-CoV-2 lose binding to Bamlanivimab in vitro, MAbs, doi:10.1080/19420862.2021.1919285
Ly-Cov555 Study Grouplundgren, Grund, Barkauskas, A neutralizing monoclonal antibody for hospitalized patients with Covid-19, N Engl J Med, doi:10.1056/NEJMoa2033130
Mcginley, Only one Covid-19 treatment is designed to keep people out of the hospital
Pallotta, Kim, Gordon, Monoclonal antibodies for treating COVID-19, Cleve Clin J Med, doi:10.3949/ccjm.88a.ccc074
Starr, Greaney, Dingens, Complete map of SARS-CoV-2 RBD mutations that escape the monoclonal antibody LY-CoV555 and its cocktail with LY-CoV016, Cell Rep Med
Tuccori, Ferraro, Convertino, Anti-SARS-CoV-2 neutralizing monoclonal antibodies: clinical pipeline, MAbs, doi:10.1080/19420862.2020.1854149
Tulledge-Scheitel, Bell, Larsen, A mobile unit overcomes the challenges to monoclonal antibody infusion for COVID-19 in skilled care facilities, J Am Geriatr Soc, doi:10.1111/jgs.17090
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Late treatment
is less effective
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