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Am J Health Syst Pharm . The impact of COVID-19 monoclonal antibodies on clinical outcomes: A retrospective cohort study

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  • Am J Health Syst Pharm . The impact of COVID-19 monoclonal antibodies on clinical outcomes: A retrospective cohort study


    Am J Health Syst Pharm


    . 2022 Oct 15;zxac295.
    doi: 10.1093/ajhp/zxac295. Online ahead of print.
    The impact of COVID-19 monoclonal antibodies on clinical outcomes: A retrospective cohort study


    Arielle R Nagler 1 , Leora I Horwitz 2 , Simon Jones 3 , Christopher M Petrilli 4 , Eduardo Iturrate 5 , Jennifer L Lighter 6 , Michael Phillips 7 , Brian P Bosworth 8 , Bruce Polsky 9 , Frank M Volpicelli 5 , Isaac Dapkins 10 , Anand Viswanathan 5 , Fritz Fran├žois 11 , Gary Kalkut 12



    Affiliations

    Abstract

    Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
    Purpose: Despite progress in the treatment of coronavirus disease 2019 (COVID-19), including the development of monoclonal antibodies (mAbs), more clinical data to support the use of mAbs in outpatients with COVID-19 is needed. This study is designed to determine the impact of bamlanivimab, bamlanivimab/etesevimab, or casirivimab/imdevimab on clinical outcomes within 30 days of COVID-19 diagnosis.
    Methods: A retrospective cohort study was conducted at a single academic medical center with 3 campuses in Manhattan, Brooklyn, and Long Island, NY. Patients 12 years of age or older who tested positive for COVID-19 or were treated with a COVID-19-specific therapy, including COVID-19 mAb therapies, at the study site between November 24, 2020, and May 15, 2021, were included. The primary outcomes included rates of emergency department (ED) visit, inpatient admission, intensive care unit (ICU) admission, or death within 30 days from the date of COVID-19 diagnosis.
    Results: A total of 1,344 mAb-treated patients were propensity matched to 1,344 patients with COVID-19 patients who were not treated with mAb therapy. Within 30 days of diagnosis, among the patients who received mAb therapy, 101 (7.5%) presented to the ED and 79 (5.9%) were admitted. Among the patients who did not receive mAb therapy, 165 (12.3%) presented to the ED and 156 (11.6%) were admitted (relative risk [RR], 0.61 [95% CI, 0.50-0.75] and 0.51 [95% CI, 0.40-0.64], respectively). Four mAb patients (0.3%) and 2.64 control patients (0.2%) were admitted to the ICU (RR, 01.51; 95% CI, 0.45-5.09). Six mAb-treated patients (0.4%) and 3.37 controls (0.3%) died and/or were admitted to hospice (RR, 1.61; 95% CI, 0.54-4.83). mAb therapy in ambulatory patients with COVID-19 decreases the risk of ED presentation and hospital admission within 30 days of diagnosis.

    Keywords: COVID-19; SARS-CoV-2; antibodies; bamlanivimab; casirivimab; imdevimab; monoclonal.

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