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All Studies   Meta Analysis    Recent:   

Real-world Effectiveness of Casirivimab and Imdevimab in Patients With COVID-19 in the Ambulatory Setting: An Analysis of Two Large US National Claims Databases

Wei et al., medRxiv, doi:10.1101/2022.02.28.22270796
Feb 2022  
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Death/hospitalization 61% Improvement Relative Risk Hospitalization 61% Casirivimab/i..  Wei et al.  EARLY TREATMENT Is early treatment with casirivimab/imdevimab beneficial for COVID-19? Retrospective 19,564 patients in the USA (December 2020 - June 2021) Lower death/hosp. (p<0.0001) and hospitalization (p<0.0001) c19early.org Wei et al., medRxiv, February 2022 Favorscasirivimab/im.. Favorscontrol 0 0.5 1 1.5 2+
17th treatment shown to reduce risk in March 2021
 
*, now with p = 0.000055 from 29 studies, recognized in 45 countries. Efficacy is variant dependent.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19early.org
Retrospective 4,396 casirivimab/imdevimab patients in the USA, showing lower combined mortality/hospitalization (CDM database) and lower hospitalization (PMTX+ database) with treatment.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants1-6.
risk of death/hospitalization, 61.0% lower, HR 0.39, p < 0.001, treatment 23 of 1,116 (2.1%), control 27 of 5,291 (0.5%), Optum CDM, Cox proportional hazards.
risk of hospitalization, 61.0% lower, HR 0.39, p < 0.001, treatment 59 of 3,280 (1.8%), control 75 of 16,284 (0.5%), IQVIA PMTX+, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Wei et al., 28 Feb 2022, retrospective, database analysis, USA, preprint, 8 authors, study period December 2020 - June 2021.
This PaperCasirivimab/i..All
Real-world Effectiveness of Casirivimab and Imdevimab in Patients With COVID-19 in the Ambulatory Setting: An Analysis of Two Large US National Claims Databases
PhD Wenhui Wei, Dana Murdock, Jessica J Jalbert, Vera Mastey, Robert J Sanchez, Boaz Hirshberg, David M Weinreich, PhD Mohamed Hussein
doi:10.1101/2022.02.28.22270796
Background: In a phase III clinical trial, casirivimab and imdevimab (CAS+IMD) reduced the composite endpoint of COVID-19-related hospitalizations or all-cause mortality in outpatients at risk of severe disease. This study assessed real-world effectiveness of CAS+IMD. Methods: Data from Optum ® Clinformatics ® Data Mart (CDM) and IQVIA Pharmetrics Plus (PMTX+) were used to identify patients diagnosed with COVID-19 in ambulatory settings between December 2020 and March 2021 (PMTX+) and June 2021 (CDM), and either treated with CAS+IMD or untreated but treatment-eligible under Emergency Use Authorization. CAS+IMD-treated patients were matched to untreated patients and followed up to 30 days for the outcome of all-cause mortality or COVID-19-related hospitalizations (CDM) and COVID-19-related hospitalizations (PMTX+). Kaplan-Meier estimators were used to calculate outcome risks; Cox proportional-hazard models estimated adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Results: For CDM, 1116 CAS+IMD-treated patients were matched to 5294 untreated patients; for PMTX+, 3280 CAS+IMD-treated patients were matched to 16,284 untreated patients. The 30-day outcome risk was 2.1% and 5.3% in treated and untreated cohorts, respectively (CDM), and the 30-day risk of COVID-19-related hospitalization was 1.9% and 4.8%, respectively (PMTX+); translating to a 61% lower adjusted outcome risk (CDM aHR 0.39 (95% CI 0.26-0.60; PMTX+ aHR 0.39 (95% CI 0.30-0.51). The benefit of treatment was maintained across multiple subgroups of highrisk patients; earlier intervention was associated with improved outcomes. . Conclusions: This real-world study further supports randomized clinical trial findings that treatment with CAS+IMD reduces the risk of hospitalization and mortality in patients infected with susceptible variants. .
A) Diagnosed with or tested positive for COVID-19 during the study period (n=566 755) Received CAS+IMD during the study period (n=1588)
References
Anderson, Smith, Edupuganti, Yan, Masi et al., Effect of Monoclonal Antibody Treatment on Clinical Outcomes in Ambulatory Patients With Coronavirus Disease 2019, Open Forum Infect Dis
Bierle, Ganesh, Tulledge-Scheitel, Monoclonal Antibody Treatment of Breakthrough COVID-19 in Fully Vaccinated Individuals with High-Risk Comorbidities, J Infect Dis
Cavazzoni, Coronavirus (COVID-19) Update: FDA Limits Use of Certain Monoclonal Antibodies to Treat COVID-19 Due to the Omicron Variant
Charlson, Pompei, Ales, Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis
Chilimuri, Mantri, Gurjar, Implementation and outcomes of monoclonal antibody infusion for COVID-19 in an inner-city safety net hospital: A South-Bronx experience, J Natl Med Assoc
Close, Jones, Jentoft, Mcauley, Outcome Comparison of High-Risk Native American Patients Who Did or Did Not Receive Monoclonal Antibody Treatment for COVID-19, JAMA Netw Open
Cooper, Christensen, Salazar, Real-world Assessment of 2,879 COVID-19 Patients Treated with Monoclonal Antibody Therapy: A Propensity Score-Matched Cohort Study, Open Forum Infect Dis
Falcone, Tiseo, Valoriani, Efficacy of Bamlanivimab/Etesevimab and Casirivimab/Imdevimab in Preventing Progression to Severe COVID-19 and Role of Variants of Concern, Infect Dis Ther
Ganesh, Philpot, Bierle, Real-World Clinical Outcomes of Bamlanivimab and Casirivimab-Imdevimab among High-Risk Patients with Mild to Moderate Coronavirus Disease 2019, J Infect Dis
Hall, Wellner, Confidence bands for a survival curve from censored data, Biometrika
Kakinoki, Yamada, Tanino, Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Monoclonal Antibody Infusions in High-Risk Outpatients, Open Forum Infect Dis
Kaplan, Meier, Nonparametric estimation from incomplete observations, J Am Stat Assoc
Linden, Samuels, Using balance statistics to determine the optimal number of controls in matching studies, J Eval Clin Pract
Mccreary, Bariola, Wadas, Association of subcutaneous or intravenous route of administration of casirivimab and imdevimab monoclonal antibodies with clinical outcomes in COVID-19, medRxiv, doi:10.1101/2021.11.30.21266756
Planas, Saunders, Maes, Considerable escape of SARS-CoV-2 variant Omicron to antibody neutralization, bioRxiv
Razonable, Aloia, Anderson, A Framework for Outpatient Infusion of Antispike Monoclonal Antibodies to High-Risk Patients with Mild-to-Moderate Coronavirus Disease-19: The Mayo Clinic Model, Mayo Clin Proc
Razonable, Pawlowski, Horo, Casirivimab-Imdevimab treatment is associated with reduced rates of hospitalization among high-risk patients with mild to moderate coronavirus disease-19, EClinicalMedicine
Verderese, Stepanova, Lam, Neutralizing Monoclonal Antibody Treatment Reduces Hospitalization for Mild and Moderate COVID-19: A Real-World Experience, Clin Infect Dis, doi:10.1093/cid/ciab579
Webb, Buckel, Vento, Real-world Effectiveness and Tolerability of Monoclonal Antibody Therapy for Ambulatory Patients With Early COVID-19, Open Forum Infect Dis
Weinreich, Sivapalasingam, Norton, REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19, N Engl J Med
Wilhelm, Widera, Grikscheit, Reduced neutralization of SARS-CoV-2 Omicron variant by vaccine sera and monoclonal antibodies, medRxiv, doi:.org/10.1101/2021.12.07.21267432
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This study assessed real-world effectiveness of ' 'CAS+IMD.</jats:p><jats:p><jats:bold>Methods</jats:bold></jats:p><jats:p>Data from ' 'Optum<jats:sup>®</jats:sup> Clinformatics<jats:sup>®</jats:sup> Data Mart (CDM) and IQVIA ' 'Pharmetrics Plus (PMTX+) were used to identify patients diagnosed with COVID-19 in ambulatory ' 'settings between December 2020 and March 2021 (PMTX+) and June 2021 (CDM), and either treated ' 'with CAS+IMD or untreated but treatment-eligible under Emergency Use Authorization. ' 'CAS+IMD-treated patients were matched to untreated patients and followed up to 30 days for ' 'the outcome of all-cause mortality or COVID-19-related hospitalizations (CDM) and ' 'COVID-19-related hospitalizations (PMTX+). Kaplan-Meier estimators were used to calculate ' 'outcome risks; Cox proportional-hazard models estimated adjusted hazard ratios (aHR) with 95% ' 'confidence intervals (CI).</jats:p><jats:p><jats:bold>Results</jats:bold></jats:p><jats:p>For ' 'CDM, 1116 CAS+IMD-treated patients were matched to 5294 untreated patients; for PMTX+, 3280 ' 'CAS+IMD-treated patients were matched to 16,284 untreated patients. The 30-day outcome risk ' 'was 2.1% and 5.3% in treated and untreated cohorts, respectively (CDM), and the 30-day risk ' 'of COVID-19-related hospitalization was 1.9% and 4.8%, respectively (PMTX+); translating to a ' '61% lower adjusted outcome risk (CDM aHR 0.39 (95% CI 0.26–0.60; PMTX+ aHR 0.39 (95% CI ' '0.30–0.51). 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