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31 casirivimab/imdevimab COVID-19 controlled studies, 10 RCTs
47% improvement
for early treatment, RR
0.53
[0.40-0.71]
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Regeneron (RCT)
38%
0.62 [0.29-1.33]
recov. time
92 (n)
91 (n)
Improvement, RR [CI]
Treatment
Control
Regeneron (RCT)
54%
0.46 [0.19-1.13]
recov. time
92 (n)
91 (n)
Regeneron (RCT)
71%
0.29 [0.17-0.48]
death/hosp.
18/1,355
62/1,341
Regeneron (RCT)
70%
0.30 [0.13-0.68]
death/hosp.
7/736
24/748
Regeneron (RCT)
29%
0.71 [0.60-0.85]
recov. time
1,355 (n)
1,341 (n)
Regeneron (RCT)
29%
0.71 [0.60-0.85]
recov. time
736 (n)
748 (n)
Weinreich (RCT)
50%
0.50 [0.09-2.72]
death
2/2,091
4/2,089
Weinreich (RCT)
67%
0.33 [0.03-3.17]
death
1/1,355
3/1,341
Weinreich (RCT)
-2%
1.02 [0.06-16.2]
death
1/736
1/748
Weinreich (RCT)
71%
0.29 [0.17-0.48]
death/hosp.
18/1,355
62/1,341
Weinreich (RCT)
70%
0.30 [0.13-0.68]
death/hosp.
7/736
24/748
Weinreich (RCT)
29%
0.71 [0.58-0.87]
recov. time
1,355 (n)
1,341 (n)
Weinreich (RCT)
29%
0.71 [0.58-0.87]
recov. time
736 (n)
748 (n)
Webb
98%
0.0 [0.00-2e+05]
death
0/115
57/5,536
Webb
91%
0.09 [0.01-0.63]
hosp.
1/115
538/5,536
Cooper
77%
0.23 [0.03-1.65]
death
1/1,148
33/8,534
Cooper
48%
0.52 [0.23-1.20]
ICU
6/1,148
85/8,534
Cooper
52%
0.48 [0.35-0.64]
hosp.
45/1,148
703/8,534
Kakinoki
58%
0.42 [0.17-0.92]
progression
13/55
22/53
Komagamine
77%
0.23 [0.01-4.63]
ventilation
0/53
2/75
Komagamine
92%
0.08 [0.01-0.90]
ICU
0/53
7/75
Komagamine
68%
0.32 [0.13-0.68]
progression
8/53
33/75
Komagamine
29%
0.71 [0.58-0.87]
hosp. time
53 (n)
75 (n)
Suzuki (PSM)
-200%
3.00 [0.12-73.3]
death
1/222
0/222
Suzuki
60%
0.40 [0.05-3.45]
death
1/314
5/635
Suzuki (PSM)
45%
0.55 [0.31-0.96]
progression
17/222
31/222
Suzuki
50%
0.50 [0.31-0.80]
progression
34/314
70/365
O'Brien (DB RCT)
85%
0.15 [0.01-2.78]
hosp.
0/100
3/104
O'Brien (DB RCT)
92%
0.08 [0.01-0.77]
hosp./ER
0/100
6/104
O'Brien (DB RCT)
33%
0.67 [0.43-0.98]
symp. case
29/100
44/104
O'Brien (DB RCT)
40%
0.60 [0.45-0.81]
viral load
100 (n)
104 (n)
Shopen
-46%
1.46 [0.73-2.67]
severe case
24/116
26/243
Osugi
24%
0.76 [0.23-2.49]
hosp.
4/30
15/74
Wei
61%
0.39 [0.26-0.60]
death/hosp.
23/1,116
27/5,291
Wei
61%
0.39 [0.30-0.51]
hosp.
59/3,280
75/16,284
Wilden
82%
0.18 [0.05-0.50]
hosp.
n/a
n/a
Faraone
92%
0.08 [0.01-0.83]
death
0/11
8/23
Faraone
94%
0.06 [0.00-0.76]
oxygen
0/11
15/23
Miyashita
33%
0.67 [0.11-3.97]
ventilation
2/461
3/461
Miyashita
46%
0.54 [0.35-0.82]
oxygen
30/461
56/461
Levey
31%
0.69 [0.07-7.37]
ICU
1/36
2/50
Levey
7%
0.93 [0.16-5.26]
oxygen
2/36
3/50
Levey
-108%
2.08 [0.81-5.33]
hosp.
9/36
6/50
Kneidinger
97%
0.03 [0.00-264]
severe case
0/3
34/215
Williams
-21%
1.21 [0.14-9.86]
oxygen
1/88
6/676
Williams
-1%
1.01 [0.12-8.01]
severe case
1/88
7/676
Williams
14%
0.86 [0.10-6.63]
hosp.
1/88
8/676
Gershengorn
-95%
1.95 [0.86-4.18]
hosp.
369 (n)
5,915 (n)
Gershengorn (PSM)
-105%
2.05 [1.23-3.42]
hosp.
21/369
41/1,476
Gershengorn (PSM)
-100%
2.00 [0.99-4.06]
hosp.
11/213
22/852
Gershengorn (PSM)
-111%
2.11 [1.00-4.44]
hosp.
10/156
19/624
Hussein (PSM)
60%
0.40 [0.38-0.42]
death/hosp.
population-based cohort
Kip
46%
0.54 [0.41-0.71]
death/hosp.
61/1,479
227/2,954
Horby (RCT)
6%
0.94 [0.86-1.02]
death
943/4,839
1,029/4,946
Horby (RCT)
-1%
1.01 [0.90-1.14]
ventilation
484/4,556
488/4,642
Horby (RCT)
21%
0.79 [0.69-0.91]
death
396/1,633
452/1,520
Horby (RCT)
13%
0.87 [0.73-1.05]
ventilation
190/1,599
202/1,484
Somersa.. (DB RCT)
3%
0.97 [0.56-1.69]
death
804 (n)
393 (n)
Somersa.. (DB RCT)
36%
0.64 [0.44-0.93]
death
59/804
45/393
Somersa.. (DB RCT)
-57%
1.57 [0.93-2.64]
death
44/110
13/51
Somersa.. (DB RCT)
3%
0.97 [0.53-1.76]
death
13/23
7/12
Somersa.. (DB RCT)
31%
0.69 [0.50-0.95]
death/int.
82/804
58/393
Somersa.. (DB RCT)
30%
0.70 [0.52-0.94]
no disch.
90/804
63/393
McCreary (PSM)
93%
0.07 [0.01-0.51]
death
1/652
29/1,304
McCreary (PSM)
56%
0.44 [0.28-0.68]
death/hosp.
22/652
101/1,304
McCreary (PSM)
48%
0.52 [0.33-0.82]
hosp.
22/652
85/1,304
McCreary (PSM)
40%
0.60 [0.43-0.85]
hosp./ER
40/652
133/1,304
Iustila-Maran (ICU)
-16%
1.16 [0.53-2.54]
death
14/50
7/29
ICU patients
Shah
-14%
1.14 [0.45-2.91]
death
8/50
7/50
Shah
0%
1.00 [0.41-2.46]
ventilation
8/50
8/50
Shah
14%
0.86 [0.54-1.39]
ICU
19/50
22/50
Shah
-43%
1.43 [0.00-1565]
ICU
50 (n)
50 (n)
Shah
4%
0.96 [0.63-1.45]
oxygen
23/50
24/50
Shah
12%
0.88 [0.60-1.28]
hosp. time
50 (n)
50 (n)
Regeneron (RCT)
94%
0.06 [0.01-0.50]
symp. case
0/186
8/223
Regeneron (RCT)
48%
0.52 [0.25-1.07]
cases
10/186
23/223
Regeneron (DB RCT)
92%
0.08 [0.01-0.79]
hosp.
0/841
6/842
Regeneron (DB RCT)
81%
0.19 [0.12-0.30]
cases
20/841
108/842
Regeneron (DB RCT)
82%
0.18 [0.08-0.41]
cases
7/841
38/842
Regeneron (DB RCT)
89%
0.11 [0.01-2.06]
hosp./ER
0/753
4/752
Regeneron (DB RCT)
81%
0.19 [0.10-0.35]
symp. case
11/753
59/752
Regeneron (DB RCT)
62%
0.38 [0.23-0.61]
recov. time
753 (n)
752 (n)
Regeneron (DB RCT)
69%
0.31 [0.17-0.55]
viral time
753 (n)
752 (n)
Isa (DB RCT)
93%
0.07 [0.01-0.28]
symp. case
3/729
13/240
Isa (DB RCT)
93%
0.07 [0.01-0.28]
cases
0/729
10/240
Bes-Berlandier
-67%
1.67 [0.69-4.06]
progression
5/17
13/74
Isa (RCT)
-37%
1.37 [0.57-3.32]
symp. case
35/245
5/48
Casirivimab/imdevimab COVID-19 outcomes
c19 early .org
December 2024
Favors casirivimab/im..
Favors control
Figure S2. Comparison of results for RCTs versus observational studies.
For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.
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