Casirivimab-Imdevimab Treatment in Mild to Moderate COVID-19: A Real-World Evidence

Results

The median age of the antibody-treated cohort was 63 years (interquartile range, 52-71);45.5% ≥ 65 years old: 51.4% were female.

• High-risk characteristics were hypertension (52.4%), body mass index ≥ 35 (31.0%), diabetes mellitus (24.6%), chronic lung disease (22.1%), chronic renal disease (11.4%), congestive heart failure(6.6%), and compromised immune function (6.7%).
  

All-cause hospitalization

• All-cause hospitalization rates were significantly lower in the casirivimab-imdevimab group than the propensity-matched cohort:

• At day 14(1.3%vs 3.3%:Absolute Difference: 2.0%: 95% CI:0.50-3.7%)

• At day 21(1.3% vs 4.2%: Absolute Difference: 2.9%: 95% CI: 1.2% - 4.7%)

• At day 28 ( 1.6% vs 4.8%: Absolute Difference: 3.2%: 95% CI:1.4-5.1%)

• Patients who were treated with casirivimab - imdevimab had significantly more hospitalization-free days.

Intensive care unit admissions and all-cause mortality

• All-cause ICU admission rates were similarly low and were not significantly different between the casirivimab-imdevimab-treated and the untreated cohorts

• Five patients died from any cause (among which only one patient received casirivimab-imdevimab).

Adverse events

• Adverse events were reported in seven patients [fever (n=4), shortness of breath (n=2), nausea(n=2), chest pain, headache, or flushing (n=1)].
• No patient had anaphylaxis. All adverse events were mild (NCI Grade 1) and did not require hospitalization.

Among high-risk patients with mild to moderate COVID-19, casirivimab-imdevimab treatment was associated with a significantly lower rate of hospitalization with uncommon and mild adverse events.

Clinical Implication

The clinical outcomes in this study complement the virologic outcomes data in the randomized controlled trial and collectively provide data to support the use of casirivimab-imdevimab as early treatment of high-risk patients with mild to moderate COVID-19.

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Reference:

"Razonable RR, Pawlowski C, O'Horo JC, et al. Casirivimab-lmdevimab treatment is associated with reduced rates of hospitalization among high-risk patients with mild to moderate coronavirus disease-19. EClinicalMedicine. 2021Aug 30:101102. doi: 10.101ó/j.eclinm.2021.101102. Epub ahead of print.

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