Comparative Efficacy of Early COVID-19 Monoclonal Antibody Therapies: A Retrospective Analysis

Savanna San Filippo, Brynna Crovetto, John Bucek, Ronald G Nahass, Marc Milano, Luigi Brunetti, Savanna San Filippo, Brynna Crovetto, John Bucek, Ronald G Nahass, Marc Milano, Luigi Brunetti

Abstract

Background: Bamlanivimab and casirivimab/imdevimab are monoclonal antibody (mAb) treatments used for mild to moderate coronavirus disease 2019 (COVID-19) in high-risk patients. To date, there are few data summarizing real-world evidence comparing the 2 mAbs. Additionally, there are insufficient data to guide administration timing relative to symptom onset. The purpose of this study was to evaluate 30-day failure rates for each agent and to identify the relationship between symptom onset and efficacy.

Methods: We performed a retrospective cohort study of a 6-month period at a large community medical center. Consecutive outpatients diagnosed with COVID-19 disease by nasopharyngeal (NP) polymerase chain reaction (PCR) testing received either bamlanivimab 700 mg or casirivimab/imdevimab 1200 mg/1200 mg. Each patient was followed for a total of 30 days. Three independent, blinded physicians performed adjudication for revisit reasons. The primary outcome was therapy-related failure, defined as COVID-19-related hospital admission within 30 days of infusion. Multivariable logistic regression was performed to adjust for confounders that may have influenced hospital admission in either group.

Results: During the period from November 2020 to May 2021, 183 patients were treated with bamlanivimab and 270 with casirivimab/imdevimab. The mean age was ~67 years and body mass index 30 kg/m2. Thirty-day admission for therapy-related failure rates were 4.8% and 13.7% for casirivimab/imdevimab and bamlanivimab, respectively (P = .001). No significant differences were found between early (<3 days of symptom onset) and late administration of either mAb.

Conclusions: There was a higher failure rate with bamlanivimab vs casirivimab/imdevimab. No difference in efficacy was found between early vs late administration of either mAb.

Keywords: COVID-19; SARS-CoV-2; antispike protein; comparative efficacy; coronavirus; protein therapeutics.

© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

References

    1. Fact Sheet for Health Care Providers: Emergency Use Authorization of Bamlanivimab [Fact Sheet, Revoked]. Eli Lilly and Company; 2021.
    1. Fact Sheet for Health Care Providers: Emergency Use Authorization of Casirivimab and Imdevimab [Fact Sheet]. Regeneron Pharmaceuticals; 2021.
    1. Fact Sheet for Health Care Providers: Emergency Use Authorization of Bamlanivimab and Etesivimab [Fact Sheet]. Eli Lilly and Company; 2021.
    1. Chen O, Nirula A, Gottlieb RL, et al. ; for the BLAZE-1 Investigators. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19. N Engl J Med 2021; 384:229–37.
    1. Fact Sheet for Health Care Providers: Emergency Use Authorization of Sotrovimab [Fact Sheet]. GlaxoSmithKline LLC; 2021.
    1. Razzaghi H, Tinker SC, Herring AH, Howards PP, Waller DK, Johnson CY.. Impact of missing data for body mass index in epidemiologic study. Matern Child Health J 2016; 20:1497–505.
    1. Sabbatini AK, Wright B.. Excluding observation stays from readmission rates – what quality measures are missing. N Engl J Med 2018; 378:2060–5.
    1. Center for Disease Control and Prevention. Science brief: Omicron (B.1.1.529) variant. Updated 2 December 2021. Available at: . Accessed 3 December 2021.
    1. Cavazzoni, P. FDA statement: coronavirus (COVID-19) update: FDA limits use of certain monoclonal antibodies to treat COVID-19 due to the omicron variant. 2022. Available at: . Accessed 15 January 2022.
    1. Blecker S, Jones SA, Petrilli CM, et al. . Hospitalizations for chronic disease and acute conditions in the time of COVID-19. JAMA Intern Med 2021; 181:269–71.
    1. Corwim DS, Ender PT, Jahre JA.. The efficacy of bamlanivimab in reducing emergency department visits and hospitalizations in a real world setting. Open Forum Infect Dis 2021; XXX:XXX–XX.
    1. Blonde L, Khunti K, Harris SB, Meizinger C, Skolnik NS.. Interpretation and impact of real-world clinical data for the practicing clinician. Adv Ther 2018; 35:1763–74.
    1. Aoki FY, Macleod MD, Paggiaro P, et al. . Early administration of oral oseltamivir increases the benefits of influenza treatment. J Antimicrob Chemother 2003; 51:123–9.
    1. Wagstaff AJ, Faulds D, Goa KL.. Acyclovir: a reappraisal of its antiviral activity, pharmacokinetic properties and therapeutic efficacy. Drugs 1994; 47:153–205.
    1. RECOVERY Collaborative Group, Horby PW, Mafham M, et al. . Casirivimab and imdevimab in patients admitted to hospital with Covid-19 (RECOVERY): a randomised, controlled, open-label, platform trial – the RECOVERY Collaborative Group. medRxiv 2021.06.12.21258542 [Preprint]. 16 June 2021. Available at: 10.1101/2021.06.15.21258542. Accessed 15 January 2022.
    1. Wiltz JL, Feehan AK, Molinari NM, et al. . Racial and ethnic disparities in receipt of medications for treatment of COVID-19 — United States, March 2020–August 2021. MMWR Morb Mortal Wkly Rep 2022; 71:96–102.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel