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Casirivimab/imdevimab COVID-19 studies. Efficacy is variant dependent. In Vitro studies suggest a lack of efficacy for omicron. Monoclonal antibody use with variants can be associated with prolonged viral loads, clinical deterioration, and immune escape. Recently added: O'Brien Kakinoki Komagamine. Casirivimab/imdevimab has been officially adopted for early treatment in 13 countries. Submit updates/corrections.
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Jan 22
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
Casirivimab/imdevimab for COVID-19: real-time meta analysis of 15 studies
Details   • Statistically significant improvements are seen for mortality, hospitalization, progression, recovery, cases, and viral clearance. 13 studies from 8 independent teams in 3 different countries show statistically significant improvements ..
Jan 14
Early O'Brien et al., JAMA, doi:10.1001/jama.2021.24939768 (Peer Reviewed)
hosp., ↓85.5%, p=0.25
Effect of Subcutaneous Casirivimab and Imdevimab Antibody Combination vs Placebo on Development of Symptomatic COVID-19 in Early Asymptomatic SARS-CoV-2 Infection: A Randomized Clinical Trial
Details   RCT 204 asymptomatic COVID+ patients, 100 treated with subcutaneous casirivimab/imdevimab, showing lower development of symptoms, lower hospitalization, and faster viral clearance with treatment. Study conducted prior to widespread circul..
Dec 21
Early Suzuki et al., medRxiv, doi:10.1101/2021.12.19.21268078 (Preprint)
death, ↑200.0%, p=1.00
Real-world clinical outcomes of treatment with casirivimab-imdevimab among patients with mild-to-moderate coronavirus disease 2019 during the Delta variant pandemic
Details   Retrospective 949 patients in Japan, 314 treated with casirivimab/imdevimab showing significantly lower risk of deterioration with treatment.
Dec 20
In Vitro Sheward et al., bioRxiv, doi:10.1101/2021.12.19.473354 (Preprint) (In Vitro)
In Vitro
Variable loss of antibody potency against SARS-CoV-2 B.1.1.529 (Omicron)
Details   In Vitro study showing that omicron is substantially resistant to neutralization by monoclonal antibodies REGN10933, REGN10987, Ly-CoV016 and Ly-CoV555. S309 (the parent of Sotrovimab) had only 2-fold loss in potency.
Dec 19
Early Komagamine et al., Journal of General and Family Medicine, doi:10.1002/jgf2.516 (Peer Reviewed)
ventilation, ↓77.3%, p=0.51
The effect of casirivimab with imdevimab on disease progression in nonsevere COVID‐19 patients in a single hospital in Japan
Details   Combined retrospective/prospective study in Japan with 53 casirivimab/imdevimab patients and 75 control patients, showing significantly lower progression with treatment.
Dec 17
In Vitro VanBlargan et al., bioRxiv, doi:10.1101/2021.12.15.472828 (Preprint) (In Vitro)
In Vitro
An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by several therapeutic monoclonal antibodies
Details   In vitro study (Vero-TMPRSS2 and Vero-hACE2-TMPRSS2) showing complete loss of inhibitory activity for B.1.1.529 omicron with LY-CoV555, LY-CoV016, REGN10933, REGN10987, and CT-P59, ~12-fold decrease for COV2-2196/COV2-2130, and minimal ch..
Dec 15
In Vitro Liu et al., bioRxiv, doi:10.1101/2021.12.14.472719 (Preprint) (In Vitro)
In Vitro
Striking Antibody Evasion Manifested by the Omicron Variant of SARS-CoV-2
Details   In vitro study (Vero-E6-TMPRSS2) showing 18 of 19 monoclonal antibodies were no longer effective or significantly impaired with B.1.1.529 omicron.
Dec 1
Late McCreary et al., medRxiv, doi:10.1101/2021.11.30.21266756 (Preprint)
death, ↓93.0%, p=0.009
Association of subcutaneous or intravenous route of administration of casirivimab and imdevimab monoclonal antibodies with clinical outcomes in COVID-19
Details   Prospective study comparing subcutaneous and intravenous casirivimab/imdevimab, and comparing to a PSM matched control set, showing significantly lower mortality and hospitalization with treatment. Controls were matched with EUA-eligible ..
Nov 16
PrEPPEP Isa et al., medRxiv, doi:10.1101/2021.11.10.21265889 (Preprint)
symp. case, ↓92.6%, p=0.002
Repeat Subcutaneous Administration of REGEN-COV® in Adults is Well-Tolerated and Prevents the Occurrence of COVID-19
Details   RCT 969 patients, 729 treated with monthly subcutaneous casirivimab/imdevimab, showing significantly lower risk of COVID-19 with treatment. There were no grade 3 injection site reactions or hypersensitivity reactions. Slightly more TEAEs ..
Nov 8
Late Somersan-Karakaya et al., medRxiv, doi:10.1101/2021.11.05.21265656 (Preprint)
death, ↓35.9%, p=0.02
REGEN-COV for the Treatment of Hospitalized Patients with Covid-19
Details   RCT 1,336 hospitalized patients with symptom onset <=10 days on low-flow or no supplemental oxygen, showing lower mortality with treatment. Cohorts 2&3 were paused mid-trial due to increased deaths in the treatment arm and these results w..
Nov 8
PrEPPEP Regeneron Press Release (News)
hosp., ↓92.3%, p=0.03
New phase 3 analyses show that a single dose of REGEN-COV® (casirivimab and imdevimab) provides long-term protection against COVID-19
Details   Long-term results for PEP RCT NCT04452318, with 841 baseline seronegative casirivimab/imdevimab patients and 842 placebo patients, showing significantly lower cases with treatment.
Nov 4
Early Kakinoki et al., medRxiv, doi:10.1101/2021.10.10.21264589 (Preprint)
progression, ↓57.6%, p=0.049
Impact of Antibody Cocktail Therapy Combined with Casirivimab and Imdevimab on Clinical Outcome for Covid-19 patients in A Real-Life Setting: A Single Institute Analysis
Details   Retrospective 55 patients in Japan treated a median of 3 days from symptom onset with casirivimab/imdevimab, and 53 control patients, showing lower risk of further treatment including oxygen or antivirals.
Nov 2
In Vitro Kaleta et al., Research Square, doi:10.21203/ (Preprint) (In Vitro)
In Vitro
Antibody escape and global spread of SARS-CoV-2 lineage A.27
Details   Anaysis of antibody escape showing variant A.27 completely escaped neutralization with LY-COV555 and partially with REGN10987. B.1.617.2 escaped these antibodies in a similar manner, suggesting that L452R facilitates the escape. Authors n..
Oct 20
Early Bierle et al., The Journal of Infectious Diseases, doi:10.1093/infdis/jiab570 (preprint 10/20/2021) (Peer Reviewed)
ICU, ↓88.9%, p=0.16
Monoclonal Antibody Treatment of Breakthrough COVID-19 in Fully Vaccinated Individuals with High-Risk Comorbidities
Details   Retrospective 1,395 vaccinated COVID-19 cases, showing significantly lower hospitalization and oxygen supplementation with monoclonal antibody treatment, primarily casirivimab-imdevimab. Hospitalization was significantly associated with c..
Oct 8
Early Cooper et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab512 (Peer Reviewed)
death, ↓77.5%, p=0.18
Real-world Assessment of 2,879 COVID-19 Patients Treated with Monoclonal Antibody Therapy: A Propensity Score-Matched Cohort Study
Details   Retrospective 2,879 patients and matched controls in the USA, showing significantly lower mortality and hospitalization with bamlanivimab, bamlanivimab/etesevimab, and casirivimab/imdevimab. There was significantly lower hospitalization w..
Jun 23
Early Webb et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab331 (Peer Reviewed)
death, ↓98.3%, p=0.63
Real-World Effectiveness and Tolerability of Monoclonal Antibody Therapy for Ambulatory Patients with Early COVID-19
Details   Retrospective 115 patients treated with casirivimab/imdevimab showing lower mortality, hospital admission, and emergency department visits with treatment. Authors falsely state that "no other COVID-19 therapies for ambulatory patient..
Jun 16
Late Horby et al., medRxiv, doi:10.1101/2021.06.15.21258542 (Preprint)
death, ↓6.0%, p=0.17
Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Details   RCT 9,785 hospitalized patients in the UK showing lower mortality with casirivimab/imdevimab, with statistical significance reached for baseline seronegative patients.
May 21
Early Weinreich et al., NEJM, doi:10.1056/NEJMoa2108163 (preprint 5/21/2021) (Peer Reviewed)
death, ↓50.0%, p=0.45
REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19
Details   RCT 4,057 outpatients with >=1 risk factor for severe disease, showing significantly lower combined hospitalization/death, and significantly faster recovery with treatment. Median time from onset of symptoms 3 days. NCT04425629.
Apr 12
PrEPPEP O'Brien et al., NEJM, doi:10.1056/NEJMoa2109682 (press release 4/12/21) (Peer Reviewed)
hosp./ER, ↓88.9%, p=0.06
Subcutaneous REGEN-COV Antibody Combination to Prevent Covid-19
Details   Prophylaxis trial reporting lower hospitalization/ER and symptomatic cases, and faster recovery with 1,200mg subcutaneous casirivimab with imdevimab. The same trial has updated results available in [1]. NCT04452318.
Mar 23
Early Regeneron Press Release (Preprint)
death/hosp., ↓71.3%, p<0.0001
New phase III data shows investigational antibody cocktail casirivimab and imdevimab reduced hospitalisation or death by 70% in non-hospitalised patients with COVID-19
Details   Press release for new phase III data showing lower hospitalization/mortality, and faster symptom resolution among the subset of patients with at least one risk factor. Some variants may escape antibodies [1].
Jan 26
PrEPPEP Regeneron Press Release (Preprint)
symp. case, ↓93.6%, p=0.009
Regeneron Reports Positive Interim Data with REGEN-COV™ Antibody Cocktail used as Passive Vaccine to Prevent COVID-19
Details   Interim results of REGEN-COV prophylaxis showing 100% prevention of symptomatic infection (8/223 placebo vs. 0/186 REGEN-COV), and approximately 50% lower overall rates of infection (symptomatic and asymptomatic) (23/223 placebo vs. 10/18..
Sep 29
Early Regeneron Press Release (Preprint)
recov. time, ↓38.0%, p=0.22
Regeneron's REGN-COV2 antibody cocktail reduced viral levels and improved symptoms in non-hospitalized COVID-19 patients
Details   Analysis of the first 275 patients in a trial of the REGN-COV2 antibody cocktail showing reductions in viral load and the time to alleviate symptoms in non-hospitalized patients with COVID-19. Greatest improvements were seen with patients..
Aug 21
In Vitro Baum et al., Science, 21 Aug 2020, 369:6506, 1014-1018, doi:10.1126/science.abd0831 (Peer Reviewed) (In Vitro)
In Vitro
Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies
Details   In Vitro study showing that, under pressure from individual antibodies, mutant viruses were rapidly selected that evaded the blocking function of all individual antibodies tested, including antibodies that potently bind to highly-conserve..
Aug 21
Animal Hansen et al., Science, 21 Aug 2020, 369:6506, 1010-1014, doi:10.1126/science.abd0827 (Peer Reviewed)
animal study
Studies in humanized mice and convalescent humans yield a SARS-CoV-2 antibody cocktail
Details   Study using humanized mice and blood samples from recovered COVID-19 patients to generate antibodies targeting multiple different regions of the critical receptor-binding domain (RBD) of the SARS-CoV-2 spike protein. The spike protein on ..
Please send us corrections, updates, or comments. Vaccines and treatments are both valuable and complementary. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases mortality, morbidity, collateral damage, and the risk of endemic status. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. WCH and FLCCC provide treatment protocols.
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