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Clinical Prognosis of Patients With Mild COVID-19 Treated With Casirivimab/Imdevimab in Japan

Osugi et al., Cureus, doi:10.7759/cureus.21882

Feb 2022

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Casirivimab/imdevimab

16th treatment shown to reduce risk in March 2021

^*, now known with p = 0.000018 from 28 studies, recognized in 42 countries. Efficacy is variant dependent.

Lower risk for hospitalization, progression, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,000+ studies for 60+ treatments. c19early.org

Retrospective 104 outpatients in Japan, 30 treated with casirivimab/imdevimab, showing no significant difference in hospitalization.

Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for many omicron variants Haars, Liu, Pochtovyi, Sheward, Tatham, VanBlargan.

1. Haars et al., Prevalence of SARS-CoV-2 Omicron Sublineages and Spike Protein Mutations Conferring Resistance against Monoclonal Antibodies in a Swedish Cohort during 2022–2023, Microorganisms, doi:10.3390/microorganisms11102417.mdpi.com, doi.org.

2. Liu et al., Striking Antibody Evasion Manifested by the Omicron Variant of SARS-CoV-2, bioRxiv, doi:10.1101/2021.12.14.472719.biorxiv.org, doi.org.

3. Pochtovyi et al., In Vitro Efficacy of Antivirals and Monoclonal Antibodies against SARS-CoV-2 Omicron Lineages XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1, Vaccines, doi:10.3390/vaccines11101533.mdpi.com, doi.org.

4. Sheward et al., Variable loss of antibody potency against SARS-CoV-2 B.1.1.529 (Omicron), bioRxiv, doi:10.1101/2021.12.19.473354.biorxiv.org, doi.org.

5. Tatham et al., Lack of Ronapreve (REGN-CoV; casirivimab and imdevimab) virological efficacy against the SARS-CoV 2 Omicron variant (B.1.1.529) in K18-hACE2 mice, bioRxiv, doi:10.1101/2022.01.23.477397.biorxiv.org, doi.org.

6. VanBlargan et al., An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by several therapeutic monoclonal antibodies, bioRxiv, doi:10.1101/2021.12.15.472828.biorxiv.org, doi.org.

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risk of hospitalization, 24.0% lower, HR 0.76, p = 0.65, treatment 4 of 30 (13.3%), control 15 of 74 (20.3%), adjusted per study, multivariable, Cox proportional hazards.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Osugi et al., 3 Feb 2022, retrospective, Japan, peer-reviewed, mean age 47.8, 5 authors, study period 31 August, 2021 - 27 September, 2021.

This Paper Casirivimab/i..All

Clinical Prognosis of Patients With Mild COVID-19 Treated With Casirivimab/Imdevimab in Japan

Yasuhiro Osugi, Hitoshi Iwata, Yasushi Imai, Daiki Kobayashi, Ryutaro Hirashima

Cureus, doi:10.7759/cureus.21882

Aim: This study aimed to report clinical courses of patients who had mild coronavirus disease 2019 (COVID-19), defined as SpO 2 of 96 or higher, and treated with/without casirivimab/imdevimab in Japan, where mortality and number of severe patients were very limited compared to other resource-rich countries.

Additional Information Disclosures Human subjects: Consent was obtained or waived by all participants in this study. The Ethical Committee of Toyota Regional Medical Center issued approval #2021-kenrin13. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

References

Arentz, Yim, Klaff, Lokhandwala, Riedo et al., Characteristics and outcomes of 21 critically Ill patients with COVID-19 in Washington state, JAMA, doi:10.1001/jama.2020.4326

Dougan, Nirula, Azizad, Bamlanivimab plus etesevimab in mild or moderate COVID-19, N Engl J Med, doi:10.1056/NEJMoa2102685

Gupta, Gonzalez-Rojas, Juarez, Early treatment for COVID-19 with SARS-CoV-2 neutralizing antibody sotrovimab, N Engl J Med, doi:10.1056/NEJMoa2107934

Liu, Fang, Deng, Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei province, Chin Med J (Engl), doi:10.1097/CM9.0000000000000744

Osugi, None, Cureus, doi:10.7759/cureus.218825of5

Weinreich, Sivapalasingam, Norton, REGEN-COV antibody combination and outcomes in outpatients with COVID-19, N Engl J Med, doi:10.1056/NEJMoa2108163

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