Treatment with Casirivimab and Imdevimab Lowers Hospitalization Rates in High Risk Patients with Mild-to-Moderate COVID-19

19 May, 22

Introduction

Monoclonal antibodies casirivimab and imdevimab, have been approved under emergency use for the treatment of high- risk patients with mild-to-moderate coronavirus disease-19 (Covid-19). This authorization was based on the reduction in the viral load in a randomized clinical trial which recruited only 275 patients. Real-world clinical data to support the use of casirivimab-imdevimab for the treatment of Covid-19 patients with mild to moderate COVID-19.

Aim

To assess the outcomes of casirivimab imdevimab treatment of mild to moderate COVID-19

Method

Study Design

Retrospective cohort study.

Patient Profile

Individuals >18 years with confirmed diagnosis of Covid-19
Onset of Covid-19 symptoms within 10 days
Had at least one of the following criteria
- Age >65 years
- Body mass index (BMI) >35
- Diabetes mellitus
- Chronic kidney disease
- Immunosuppressive medication use
- Immunocompromising condition

Treatment Strategy

Demographic covariates such as age, gender, race and ethnicity were considered.
Clinical covariates, hypertension, BMI, immunosuppressive medication use and location of infusion were considered.

Endpoints

Primary Endpoint

Rate of hospitalization at days 14, 21 and 28 after infusion.

Secondary Endpoints

ICU admission
Mortality

Results

The median age of the antibody-treated cohort was 63 years; 45·5% were ≥65 years old; 51.4% were female.
The most common comorbidities were hypertension (52.4%), BMI ≥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%).
The patients who received casirivimab-imdevimab had significantly lower all-cause hospitalization rates at day 14, day 21 and day 28 than the untreated controls as shown in Figure 1.

Figure 1. Rate of hospitalization

Adverse events were mild. However, they were mild and did not require any hospitalization.

Conclusion

The results of this real-world study demonstrated that treatment with casirivimab-imdevimab significantly lowered the rate of hospitalization among high-risk patients with mild to moderate COVID-19.

EClinicalMedicine. 2021 Oct; 40:101102. Doi: 10.1016/j.eclinm.2021.101102.