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Efficacy and safety of casirivimab-imdevimab combination on COVID-19 patients: A systematic review and meta-analysis randomized controlled trial

Wicaksono et al., Heliyon, doi:10.1016/j.heliyon.2023.e22839, PROSPERO CRD42023412835
Nov 2023  
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17th treatment shown to reduce risk in March 2021
*, now known with p = 0.0000087 from 27 studies, recognized in 42 countries. Efficacy is variant dependent.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Systematic review and meta analysis showing lower mortality and progression, and improved viral load with casirivimab/imdevimab treatment.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants Haars, Liu, Pochtovyi, Sheward, Tatham, VanBlargan.
Currently there are 27 casirivimab/imdevimab studies and meta analysis shows:
Mortality40% lower [1‑64%]
Ventilation1% higher [-11‑13%]
ICU admission53% lower [-0‑78%]
Hospitalization42% lower [17‑59%]
Cases80% fewer [39‑93%]
Wicaksono et al., 27 Nov 2023, peer-reviewed, 4 authors, trial PROSPERO CRD42023412835. Contact:
This PaperCasirivimab/i..All
Efficacy and safety of casirivimab-imdevimab combination on COVID-19 patients: A systematic review and meta-analysis randomized controlled trial
Imam Adi Wicaksono, Cecep Suhandi, Khaled M Elamin, Nasrul Wathoni
Heliyon, doi:10.1016/j.heliyon.2023.e22839
Background: The advantages and disadvantages of casirivimab-imdevimab for coronavirus disease 2019 are not well understood. We conducted a systematic review and meta-analysis of relevant literature to determine the therapeutic effectiveness and potential side effects of casirivimab-imdevimab in COVID-19 patients. Methods: Databases were searched from the time of their commencement until February 28 th , 2023. The primary results evaluated were the death rate at 28 days, progression of current clinical symptoms within 28 days, viral load, discharge from hospital, and any adverse events. Also, we contrasted the effects of the casirivimab-imdevimab treatment with placebo or standard of care. The protocol registration for this systematic review and meta-analysis was recorded in the PROSPERO database (CRD42023412835). Results: A total of eight studies were included, comprising 19,819 patients, and conducted a qualitative assessment of their risk of bias using the Cochrane risk of bias tool. Casirivimabimdevimab effectively reduced the mortality rate (OR = 0.62; 95% CI of 0.40-0.98; p = 0.04; I 2 = 30%) and reduced the progression of clinical symptoms (OR = 0.86; 95% CI of 0.79-0.93; p = 0.0003; I 2 = 57%). Casirivimab-imdevimab also improved viral load clearance and hospital discharge. Additionally, the trials' findings demonstrated a slight decrease in the likelihood of adverse events occurring with the use of casirivimab-imdevimab. Conclusion: Our research suggests that casirivimab-imdevimab may be a valuable, safe, and effective anti-SARS-CoV-2 regimen.
Consent for publication Not applicable. Competing interests All authors declare no conflict of interest. Ethics approval and consent to participate Ethical approval was not needed because this is a meta-analysis. Authors' contribution IAW and CS: conceptualization; CS: methodology and software; IAW, KME, and NW: validation; IAW, CS, and NW: formal analysis; KME and NW: investigation; CS: writingoriginal draft preparation; IAW, KME, and NW: review and editing; and IAW: project administration and funding acquisition. All authors have read and agreed to the published version of the manuscript. Declaration of interests ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ☐ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: J o u r n a l P r e -p r o o f
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