Casirivimab/Imdevimab - An Indian Real World Experience : Review

The antibody cocktail (Casirivimab and Imdevimab) has been approved in India for the treatment of mild to moderate COVID-19 in adolescents and adults in specified high-risk groups. This retrospective study was conducted in two tertiary care COVID centers and included 63 COVID-19 patients from Mumbai, India. The primary objectives were time to COVID-19 symptoms resolution, the proportion of patients with disease progression, and the effect of BMI on outcomes of treatment. While secondary objectives were to evaluate the safety and all-cause mortality in patients treated with the monoclonal antibody cocktail therapy in a real-world setting.

Baseline characteristics

• The mean age was 54.87 years ± 17.83 years, and all the patients were double vaccinated. Thirty-one patients had a BMI of 25 Kg/m2, of these 11.1% of patients had a BMI of 30 Kg/m2.
• Patients most commonly present with symptoms of fever (52.4%) and cough (66.7%) and common comorbid diseases were hypertension and cardiovascular diseases (36.5%) followed by diabetes (25.4%).

Results:

• Symptoms resolution occurred earliest for fever (1.41 days ± 0.74 days) followed by the sore throat (1.59 days ± 0.80 days) then body ache resolved after 4.35 days ± 1.70 days while weakness took the longest time to resolve (6.33 days ± 2.74 days).
• Only 11 patients (17.5%) patients needed hospitalization. The total duration of hospitalization was 5.00 ± 2 days.
• None of the patients enrolled in the study needed oxygen support or experienced any adverse effects after treatment with the antibody cocktail therapy.
• BMI had no impact on prevalence or duration of symptoms or on hospitalization and O2 support.
• Similarly, there was no statistically significant correlation between BMI and time to symptom resolution such as cough (p=0.819) or fever or the need for hospitalization.

The current real world study demonstrated the efficacy and safety of casirivimab/imdevimab in preventing hospitalization and deaths in Indian COVID 19 patients and states that efficacy of casirivimab/imdevimab remains unaffected regardless of the age, bodyweight and presence of comorbid conditions.

Reference:

AgrawalV. Casirivimab/Imdevimab for Management of Mild to Moderate COVID 19: An Indian Experience. International Journal of Clinical Skills. 2022;16(4):688-95.

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