tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2021 Oct 8;8(11)
fab512.
doi: 10.1093/ofid/ofab512. eCollection 2021 Nov.
Real-world Assessment of 2879 COVID-19 Patients Treated With Monoclonal Antibody Therapy: A Propensity Score-Matched Cohort Study
Megan H Cooper[SUP] 1 [/SUP], Paul A Christensen[SUP] 2 [/SUP], Eric Salazar[SUP] 2 [/SUP], Katherine K Perez[SUP] 1 2 [/SUP], Edward A Graviss[SUP] 3 [/SUP], Duc Nguyen[SUP] 3 [/SUP], James M Musser[SUP] 2 3 [/SUP], Howard J Huang[SUP] 4 [/SUP], Michael G Liebl[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread globally and cause significant morbidity and mortality. Antispike protein monoclonal antibody (mAb) therapy has been shown to prevent progression to severe coronavirus disease 2019 (COVID-19). The objective of this study was to report the outcomes of high-risk, SARS-CoV-2-positive patients infused with 1 of the 3 mAb therapies available through Food and Drug Administration Emergency Use Authorization (EUA).
Methods: A total of 4328 SARS-CoV-2-positive patients who satisfied EUA criteria for eligibility for receiving mAb therapy were infused with bamlanivimab or the combination therapies bamlanivimab-etesevimab or casirivimab-imdevimab from November 22, 2020, to May 31, 2021, at 6 infusion clinics and multiple emergency departments within the 8 Houston Methodist Hospitals in Houston, Texas. The primary outcome of hospital admission within 14 and 28 days postinfusion was assessed relative to a propensity score-matched cohort, matched based on age, race/ethnicity, median income by zip code, body mass index, comorbidities, and positive polymerase chain reaction date. Secondary outcomes included intensive care unit admission and mortality.
Results: A total of 2879 infused patients and matched controls were included in the analysis, including 1718 patients infused with bamlanivimab, 346 patients infused with bamlanivimab-etesevimab, and 815 patients infused with casirivimab-imdevimab. Hospital admission and mortality rates were significantly decreased overall in mAb-infused patients relative to matched controls. Among the infused cohort, those who received casirivimab-imdevimab had a significantly decreased rate of admission relative to the other 2 mAb therapy groups (adjusted risk ratio,0.51; P=.001).
Conclusions: Treatment with bamlanivimab, bamlanivimab-etesevimab, or casirivimab-imdevimab significantly decreased the number of patients who progressed to severe COVID-19 disease and required hospitalization.
Keywords: SARS-CoV-2; monoclonal antibody; outpatient; passive immunity.
. 2021 Oct 8;8(11)
fab512.doi: 10.1093/ofid/ofab512. eCollection 2021 Nov.
Real-world Assessment of 2879 COVID-19 Patients Treated With Monoclonal Antibody Therapy: A Propensity Score-Matched Cohort Study
Megan H Cooper[SUP] 1 [/SUP], Paul A Christensen[SUP] 2 [/SUP], Eric Salazar[SUP] 2 [/SUP], Katherine K Perez[SUP] 1 2 [/SUP], Edward A Graviss[SUP] 3 [/SUP], Duc Nguyen[SUP] 3 [/SUP], James M Musser[SUP] 2 3 [/SUP], Howard J Huang[SUP] 4 [/SUP], Michael G Liebl[SUP] 1 [/SUP]
Affiliations
- PMID: 35559124
- PMCID: PMC9088516
- DOI: 10.1093/ofid/ofab512
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread globally and cause significant morbidity and mortality. Antispike protein monoclonal antibody (mAb) therapy has been shown to prevent progression to severe coronavirus disease 2019 (COVID-19). The objective of this study was to report the outcomes of high-risk, SARS-CoV-2-positive patients infused with 1 of the 3 mAb therapies available through Food and Drug Administration Emergency Use Authorization (EUA).
Methods: A total of 4328 SARS-CoV-2-positive patients who satisfied EUA criteria for eligibility for receiving mAb therapy were infused with bamlanivimab or the combination therapies bamlanivimab-etesevimab or casirivimab-imdevimab from November 22, 2020, to May 31, 2021, at 6 infusion clinics and multiple emergency departments within the 8 Houston Methodist Hospitals in Houston, Texas. The primary outcome of hospital admission within 14 and 28 days postinfusion was assessed relative to a propensity score-matched cohort, matched based on age, race/ethnicity, median income by zip code, body mass index, comorbidities, and positive polymerase chain reaction date. Secondary outcomes included intensive care unit admission and mortality.
Results: A total of 2879 infused patients and matched controls were included in the analysis, including 1718 patients infused with bamlanivimab, 346 patients infused with bamlanivimab-etesevimab, and 815 patients infused with casirivimab-imdevimab. Hospital admission and mortality rates were significantly decreased overall in mAb-infused patients relative to matched controls. Among the infused cohort, those who received casirivimab-imdevimab had a significantly decreased rate of admission relative to the other 2 mAb therapy groups (adjusted risk ratio,0.51; P=.001).
Conclusions: Treatment with bamlanivimab, bamlanivimab-etesevimab, or casirivimab-imdevimab significantly decreased the number of patients who progressed to severe COVID-19 disease and required hospitalization.
Keywords: SARS-CoV-2; monoclonal antibody; outpatient; passive immunity.