O'Brien, 204 patient casirivimab/imdevimab early treatment RCT: 85% lower hospitalization [p=0.25], 92% fewer combined hospitalization/ER visits [p=0.03], 33% fewer symptomatic cases [p=0.04], and 40% improved viral clearance [p=0.001] https://c19p.org/obrien2
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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
et al., JAMA, doi:10.1001/jama.2021.24939768
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 circulation of delta and omicron in the study locations.Efficacy is variant dependent. Unlikely to be effective for omicron [Liu, Sheward, Tatham, VanBlargan].
1.
Liu et al., bioRxiv, doi:10.1101/2021.12.14.472719,
Striking Antibody Evasion Manifested by the Omicron Variant of SARS-CoV-2,
https://www.biorxiv.org/content/10.1101/2021.12.14.472719.
2.
Sheward et al., bioRxiv, doi:10.1101/2021.12.19.473354,
Variable loss of antibody potency against SARS-CoV-2 B.1.1.529 (Omicron),
https://www.biorxiv.org/content/10.1101/2021.12.19.473354.
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risk of hospitalization, 85.5% lower, RR 0.15, p = 0.25, treatment 0 of 100 (0.0%), control 3 of 104 (2.9%), NNT 35, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
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risk of hospitalization/ER, 92.2% lower, RR 0.08, p = 0.03, treatment 0 of 100 (0.0%), control 6 of 104 (5.8%), NNT 17, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
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risk of symptomatic case, 33.0% lower, RR 0.67, p = 0.04, treatment 29 of 100 (29.0%), control 44 of 104 (42.3%), NNT 7.5, odds ratio converted to relative risk, day 14, primary outcome.
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relative weeks with high viral load, 39.7% better, RR 0.60, p = 0.001, treatment 100, control 104.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
O'Brien et al., 1/14/2022, Double Blind Randomized Controlled Trial, placebo-controlled, multiple countries, multiple regions, peer-reviewed, 38 authors, study period 13 July, 2020 - 28 January, 2021.
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