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A Retrospective Cohort Observational Study to Assess the Efficacy of Monoclonal Antibody in Coronavirus Disease 2019 Patients

Shah et al., Journal of the Association of Physicians of India, doi:10.59556/japi.72.0646

Sep 2024

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Casirivimab/imdevimab

17th treatment shown to reduce risk in March 2021

^*, now with p = 0.00018 from 31 studies, recognized in 45 countries. Efficacy is variant dependent.

Lower risk for hospitalization, progression, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments. ^* >10% efficacy, ≥3 studies.

4,700+ studies for 95 treatments. c19early.org

PSM retrospective 100 hospitalized COVID-19 patients in India showing no benefit with casirivimab/imdevimab treatment. There were no significant differences between groups in need for oxygen therapy, high-flow nasal cannula, noninvasive ventilation, invasive ventilation, ICU admission, hospital or ICU stay, or mortality.

Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants1-6.

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risk of death, 14.3% higher, RR 1.14, p = 1.00, treatment 8 of 50 (16.0%), control 7 of 50 (14.0%).

risk of mechanical ventilation, no change, RR 1.00, p = 1.00, treatment 8 of 50 (16.0%), control 8 of 50 (16.0%).

risk of ICU admission, 13.6% lower, RR 0.86, p = 0.68, treatment 19 of 50 (38.0%), control 22 of 50 (44.0%), NNT 17.

ICU time, 42.9% higher, relative time 1.43, p = 0.93, treatment 50, control 50.

risk of oxygen therapy, 4.2% lower, RR 0.96, p = 1.00, treatment 23 of 50 (46.0%), control 24 of 50 (48.0%), NNT 50.

hospitalization time, 12.5% lower, relative time 0.88, p = 0.50, treatment 50, control 50.

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

1. Liu et al., Striking Antibody Evasion Manifested by the Omicron Variant of SARS-CoV-2, bioRxiv, doi:10.1101/2021.12.14.472719.biorxiv.org, doi.org.

2. Sheward et al., Variable loss of antibody potency against SARS-CoV-2 B.1.1.529 (Omicron), bioRxiv, doi:10.1101/2021.12.19.473354.biorxiv.org, doi.org.

3. VanBlargan et al., An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by several therapeutic monoclonal antibodies, bioRxiv, doi:10.1101/2021.12.15.472828.biorxiv.org, doi.org.

4. Tatham et al., Lack of Ronapreve (REGN-CoV; casirivimab and imdevimab) virological efficacy against the SARS-CoV 2 Omicron variant (B.1.1.529) in K18-hACE2 mice, bioRxiv, doi:10.1101/2022.01.23.477397.biorxiv.org, doi.org.

5. Pochtovyi et al., In Vitro Efficacy of Antivirals and Monoclonal Antibodies against SARS-CoV-2 Omicron Lineages XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1, Vaccines, doi:10.3390/vaccines11101533.mdpi.com, doi.org.

6. Haars et al., Prevalence of SARS-CoV-2 Omicron Sublineages and Spike Protein Mutations Conferring Resistance against Monoclonal Antibodies in a Swedish Cohort during 2022–2023, Microorganisms, doi:10.3390/microorganisms11102417.mdpi.com, doi.org.

Shah et al., 1 Sep 2024, retrospective, India, peer-reviewed, 5 authors.

This Paper Casirivimab/i..All

Late treatment
is less effective

Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.

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