Effectiveness of REGEN-COV combination monoclonal antibody infusion to reduce risk of COVID-19 hospitalization in pregnancy: A retrospective cohort study
et al., American Journal of Obstetrics and Gynecology, doi:10.1016/j.ajog.2022.09.017, Sep 2022
18th treatment shown to reduce risk in
March 2021, now with p = 0.000095 from 34 studies, recognized in 52 countries.
Efficacy is variant dependent.
No treatment is 100% effective. Protocols
combine treatments.
6,200+ studies for
200+ treatments. c19early.org
|
Retrospective 764 pregnant patients with COVID-19 in the USA, 88 treated with casirivimab/imdevimab, showing no significant difference in outcomes.
Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants1-7.
Standard of Care (SOC) for COVID-19 in the study country,
the USA, is very poor with very low average efficacy for approved treatments8.
Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
|
risk of oxygen therapy, 20.8% higher, RR 1.21, p = 0.87, treatment 1 of 88 (1.1%), control 6 of 676 (0.9%), odds ratio converted to relative risk.
|
|
risk of severe case, 1.0% higher, RR 1.01, p = 0.99, treatment 1 of 88 (1.1%), control 7 of 676 (1.0%), odds ratio converted to relative risk.
|
|
risk of hospitalization, 13.9% lower, RR 0.86, p = 0.90, treatment 1 of 88 (1.1%), control 8 of 676 (1.2%), NNT 2125, odds ratio converted to relative risk.
|
| 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.
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.
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.
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.
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.
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.
Williams et al., 12 Sep 2022, retrospective, USA, peer-reviewed, 6 authors.
Contact: frank.williams2@ochsner.org.
Effectiveness of REGEN-COV combination monoclonal antibody infusion to reduce the risk of COVID-19 hospitalization in pregnancy: a retrospective cohort study
American Journal of Obstetrics and Gynecology, doi:10.1016/j.ajog.2022.09.017
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References
Halalau, Imam, Karabon, External validation of a clinical risk score to predict hospital admission and in-hospital mortality in COVID-19 patients, Ann Med, doi:10.1080/07853890.2020.1828616
Jamieson, Rasmussen, An update on COVID-19 and pregnancy, Am J Obstet Gynecol, doi:10.1016/j.ajog.2021.08.054
Kalafat, Prasad, Birol, An internally validated prediction model for critical COVID-19 infection and intensive care unit admission in symptomatic pregnant women, Am J Obstet Gynecol, doi:10.1016/j.ajog.2021.09.024J
Weinreich, Sivapalasingam, Norton, REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19, N Engl J Med, doi:10.1056/NEJMoa2108163
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