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c19early.org COVID-19 treatment researchCasirivimab/imdevimabCasirivimab/i.. (more..)
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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 75% Improvement Relative Risk ICU admission 29% Hospitalization 67% Casirivimab/i..  Razonable et al.  EARLY TREATMENT Is early treatment with casirivimab/imdevimab beneficial for COVID-19? Retrospective 1,392 patients in the USA (December 2020 - April 2021) Lower hospitalization with casirivimab/imdevimab (p=0.0011) c19early.org Razonable et al., EClinicalMedicine, Oct 2021 Favors casirivimab/im.. Favors control

Casirivimab–Imdevimab treatment is associated with reduced rates of hospitalization among high-risk patients with mild to moderate coronavirus disease-19

Razonable et al., EClinicalMedicine, doi:10.1016/j.eclinm.2021.101102
Oct 2021  
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16th treatment shown to reduce risk in March 2021
 
*, now known with p = 0.000018 from 28 studies, recognized in 42 countries. Efficacy is variant dependent.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Retrospective 696 patients treated with casirivimab/imdevimab, and 696 matched controls, showing lower hospitalization with treatment. Authors only included patients with documented followup, which is likely to disproportionately bias the control group towards patients with worse outcomes.
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 casirivimab/imdevimab also recommended them, or because the patient seeking out casirivimab/imdevimab 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 many omicron variants Haars, Liu, Pochtovyi, Sheward, Tatham, VanBlargan.
risk of death, 75.0% lower, RR 0.25, p = 0.37, treatment 1 of 696 (0.1%), control 4 of 696 (0.6%), NNT 232.
risk of ICU admission, 28.6% lower, RR 0.71, p = 0.77, treatment 5 of 696 (0.7%), control 7 of 696 (1.0%), NNT 348.
risk of hospitalization, 66.7% lower, RR 0.33, p = 0.001, treatment 11 of 696 (1.6%), control 33 of 696 (4.7%), NNT 32.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Razonable et al., 31 Oct 2021, retrospective, USA, peer-reviewed, 18 authors, study period 4 December, 2020 - 9 April, 2021. Contact: razonable.raymund@mayo.edu.
This PaperCasirivimab/i..All
Casirivimab–Imdevimab treatment is associated with reduced rates of hospitalization among high-risk patients with mild to moderate coronavirus disease-19
Raymund R Razonable, Colin Pawlowski, John C O'horo, Lori L Arndt, Richard Arndt, Dennis M Bierle, Molly Destro Borgen, Sara N Hanson, Michelle C Hedin, Patrick Lenehan, Arjun Puranik, Maria T Seville, Leigh L Speicher, Sidna M Tulledge-Scheitel, A J Venkatakrishnan, Caroline G Wilker, Andrew D Badley, Ravindra Ganesh
EClinicalMedicine, doi:10.1016/j.eclinm.2021.101102
Background: Real-world clinical data to support the use of casirivimabÀimdevimab for the treatment of outpatients with mild to moderate coronavirus disease-19 (COVID-19) is needed. This study aimed to assess the outcomes of casirivimabÀimdevimab treatment of mild to moderate COVID-19. Methods: A retrospective cohort of 696 patients who received casirivimabÀimdevimab between December 4, 2020 and April 9, 2021 was compared to a propensity-matched control of 696 untreated patients with mild to moderate COVID-19 at Mayo Clinic sites in Arizona, Florida, Minnesota, and Wisconsin. Primary outcome was rate of hospitalization at days 14, 21 and 28 after infusion. Findings: The median age of the antibody-treated cohort was 63 years (interquartile range, 52À71); 45¢5% were 65 years old; 51.4% were female. High-risk characteristics were hypertension (52.4%), body mass index 35 (31.0%), diabetes mellitus (24.6%), chronic lung disease (22.1%), chronic renal disease (11.4%), congestive heart failure (6.6%), and compromised immune function (6.7%). Compared to the propensitymatched untreated control, patients who received casirivimabÀimdevimab had significantly lower all-cause hospitalization rates at day 14 (1.3% vs 3.3%; Absolute Difference: 2.0%; 95% confidence interval (CI): 0.5À3.7%), day 21 (1.3% vs 4.2%; Absolute Difference: 2.9%; 95% CI: 1.2À4.7%), and day 28 (1.6% vs 4.8%; Absolute Difference: 3.2%; 95% CI: 1.4À5.1%). Rates of intensive care unit admission and mortality at days 14, 21 and 28 were similarly low for antibody-treated and untreated groups. Interpretation: Among high-risk patients with mild to moderate COVID-19, casirivimabÀimdevimab treatment was associated with a significantly lower rate of hospitalization. Funding: Mayo Clinic.
Funding Mayo Clinic Contributors Concept and Design: Razonable, Pawlowski, Ganesh Acquisition, Analysis, or Interpretation of Data: Razonable, Pawlowski, Lenehan, Puranik, Venkatakrishnan, O'Horo, Badley, Ganesh Drafting of the Manuscript: Supplementary materials Supplementary material associated with this article can be found in the online version at doi:10.1016/j.eclinm.2021.101102.
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