Lack of effectiveness of Bebtelovimab monoclonal antibody among high-risk patients with SARS-Cov-2 Omicron during BA.2, BA.2.12.1 and BA.5 subvariants dominated era
Srilekha Sridhara, Ahmet B Gungor, Halil K Erol, Mohanad Al-Obaidi, Tirdad T Zangeneh, Edward J Bedrick, Venkatesh K Ariyamuthu, Aneesha Shetty, Abd A Qannus, Katherine Mendoza, Sangeetha Murugapandian, Gaurav Gupta, Bekir Tanriover
PLOS ONE, doi:10.1371/journal.pone.0279326
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron subvariants are expected to be resistant to Bebtelovimab (BEB) monoclonal antibody (MAb) and the realworld experience regarding its effectiveness is scarce. This retrospective cohort study reports a data analysis in Banner Healthcare System (a large not-for-profit organization) between 4/5/2022 and 8/1/2022 and included 19,778 Coronavirus disease-19 (COVID-19) positive (by PCR or direct antigen testing) patients who were selected from Cerner-Electronic Health Record after the exclusions criteria were met. The study index date for cohort was determined as the date of BEB MAb administration or the date of the first positive COVID-19 testing. The cohort consist of COVID-19 infected patients who received BEB MAb (N = 1,091) compared to propensity score (PS) matched control (N = 1,091). The primary composite outcome was the incidence of 30-day all-cause hospitalization and/or mortality. All statistical analyses were conducted on the paired (matched) dataset. For the primary composite outcome, the event counts and percentages were reported. Ninety-five percent Clopper-Pearson confidence intervals for percentages were computed. The study cohorts were 1:1 propensity matched without replacement across 26 covariates using an optimal matching algorithm that minimizes the sum of absolute pairwise distance across the matched sample after fitting and using logistic regression as the distance function. The pairs were matched exactly on patient vaccination status, BMI group, age group and diabetes status. Compared to the PS matched control group (2.6%; 95% confidence interval [CI]: 1.7%, 3.7%), BEB MAb use (2.2%; 95% CI: 1.4%, 3.3%) did not significantly reduce the incidence
Writing -original draft: Srilekha Sridhara, Ahmet B. Gungor, Halil K. Erol, Mohanad Al-Obaidi, Tirdad T. Zangeneh, Venkatesh K. Ariyamuthu, Aneesha Shetty, Abd A. Qannus, Katherine Mendoza, Sangeetha Murugapandian, Gaurav Gupta, Bekir Tanriover.
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