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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality -401% Improvement Relative Risk Hospitalization -101% Progression -503% Sotrovimab  COMET-TAIL  EARLY TREATMENT  RCT Is early treatment with sotrovimab beneficial for COVID-19? RCT 982 patients in the USA (August 2020 - March 2021) Trial compares with intravenous sotrovimab Higher mortality (p=0.25) and hospitalization (p=0.2), not sig. c19early.org Shapiro et al., medRxiv, March 2023 Favors sotrovimab Favors intravenous ..

Intramuscular Versus Intravenous SARS-CoV-2 Neutralizing Antibody Sotrovimab for Treatment of COVID-19 (COMET-TAIL): A Randomized Non-inferiority Clinical Trial

Shapiro et al., medRxiv, doi:10.1101/2023.03.21.23287410, COMET-TAIL, NCT04913675
Mar 2023  
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Sotrovimab for COVID-19
38th treatment shown to reduce risk in May 2023
 
*, now known with p = 0.0017 from 22 studies, recognized in 37 countries. Efficacy is variant dependent.
Lower risk for hospitalization.
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
RCT 982 high risk outpatients in the USA reporting that intramuscular sotrovimab was non-inferior to intravenous administration. Death and hospitalization was more frequent with intramuscular administration, without statistical significance due to the small number of events.
Efficacy is variant dependent. In Vitro studies predict lower efficacy for BA.1 Liu, Sheward, VanBlargan, BA.4, BA.5 Haars, XBB.1.9.3, XBB.1.5.24, XBB.2.9, CH.1.1 Pochtovyi, and no efficacy for BA.2 Zhou, ХВВ.1.9.1, XBB.1.16, BQ.1.1.45, and CL.1 Pochtovyi. US EUA has been revoked.
risk of death, 401.1% higher, RR 5.01, p = 0.25, treatment 2 of 376 (0.5%), control 0 of 378 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).
risk of hospitalization, 101.1% higher, RR 2.01, p = 0.20, treatment 10 of 376 (2.7%), control 5 of 378 (1.3%).
risk of progression, 503.2% higher, RR 6.03, p = 0.07, treatment 6 of 376 (1.6%), control 1 of 378 (0.3%), progression to severe.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Shapiro et al., 24 Mar 2023, Randomized Controlled Trial, USA, preprint, 28 authors, study period August 2020 - March 2021, this trial compares with another treatment - results may be better when compared to placebo, trial NCT04913675 (history) (COMET-TAIL). Contact: akohli@azliver.com, lgaffney@vir.bio.
This PaperSotrovimabAll
Intramuscular Versus Intravenous SARS-CoV-2 Neutralizing Antibody Sotrovimab for Treatment of COVID-19 (COMET-TAIL): A Randomized Non-inferiority Clinical Trial
Adrienne E Shapiro, Elias Sarkis, Jude Acloque, Almena Free, Yaneicy Gonzalez-Rojas, Rubaba Hussain, Erick Juarez, Jaynier Moya, Naval Parikh, David Inman, Deborah Cebrik, Ahmed Nader, Nadia Noormohamed, Qianwen Wang, Andrew Skingsley, Daren Austin, Amanda Peppercorn, Maria L Agostini, Sergio Parra, Sophia Chow, Erik Mogalian, Phillip S Pang, David K Hong, Jennifer E Sager, Wendy W Yeh, Vir Biotechnology, Inc Elizabeth L Alexander, Dr Leah A Gaffney, Dr Anita Kohli
doi:10.1101/2023.03.21.23287410
Sotrovimab 500-mg IM was non-inferior to sotrovimab 500-mg IV for treatment of mild/moderate COVID-19 in high-risk patients, measured by all-cause hospitalization >24h or death through day 29, and was well-tolerated. Sotrovimab IM should provide easier outpatient access to COVID-19 treatment.
Funding The study was supported by Vir Biotechnology, Inc. in collaboration with GSK. Author Contributions PSP, DKH, EA, WWY, EM, JES, DA, SC, and AP conceptualized and designed the study. All authors acquired, analyzed and/or interpreted the data. DI and DC conducted the statistical analyses. AK, LAG, and DI accessed and verified the data. All authors drafted the manuscript and critically reviewed and revised the manuscript for important intellectual content. All authors had full access to all the data in the study, take responsibility for the accuracy of the analysis, and had authority over manuscript preparation and the decision to submit the manuscript for publication. Conflict of Interest Disclosures
References
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