San Filippo Savanna, Crovetto Brynna, Bucek John, Nahass Ronald G, Milano Marc, Brunetti Luigi
Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, USA.
IDCare, Hillsborough, New Jersey, USA.
Open Forum Infect Dis. 2022 Feb 14;9(4):ofac080. doi: 10.1093/ofid/ofac080. eCollection 2022 Apr.
Bamlanivimab and casirivimab/imdevimab are monoclonal antibody (mAb) treatments used for mild to moderate coronavirus disease 2019 (COVID-19) in high-risk patients. To date, there are few data summarizing real-world evidence comparing the 2 mAbs. Additionally, there are insufficient data to guide administration timing relative to symptom onset. The purpose of this study was to evaluate 30-day failure rates for each agent and to identify the relationship between symptom onset and efficacy.
We performed a retrospective cohort study of a 6-month period at a large community medical center. Consecutive outpatients diagnosed with COVID-19 disease by nasopharyngeal (NP) polymerase chain reaction (PCR) testing received either bamlanivimab 700 mg or casirivimab/imdevimab 1200 mg/1200 mg. Each patient was followed for a total of 30 days. Three independent, blinded physicians performed adjudication for revisit reasons. The primary outcome was therapy-related failure, defined as COVID-19-related hospital admission within 30 days of infusion. Multivariable logistic regression was performed to adjust for confounders that may have influenced hospital admission in either group.
During the period from November 2020 to May 2021, 183 patients were treated with bamlanivimab and 270 with casirivimab/imdevimab. The mean age was ~67 years and body mass index 30 kg/m. Thirty-day admission for therapy-related failure rates were 4.8% and 13.7% for casirivimab/imdevimab and bamlanivimab, respectively ( = .001). No significant differences were found between early (<3 days of symptom onset) and late administration of either mAb.
There was a higher failure rate with bamlanivimab vs casirivimab/imdevimab. No difference in efficacy was found between early vs late administration of either mAb.
巴瑞替尼单抗和卡西瑞维单抗/依德维单抗是用于治疗高危患者轻度至中度2019冠状病毒病（COVID-19）的单克隆抗体（mAb）疗法。迄今为止，总结比较这两种单克隆抗体的真实世界证据的数据很少。此外，关于相对于症状发作的给药时间的数据也不足。本研究的目的是评估每种药物的30天失败率，并确定症状发作与疗效之间的关系。
我们在一家大型社区医疗中心进行了一项为期6个月的回顾性队列研究。通过鼻咽（NP）聚合酶链反应（PCR）检测确诊为COVID-19疾病的连续门诊患者接受700mg巴瑞替尼单抗或1200mg/1200mg卡西瑞维单抗/依德维单抗治疗。每位患者共随访30天。三名独立、不知情的医生对再次就诊原因进行判定。主要结局是与治疗相关的失败，定义为输液后30天内因COVID-19相关住院。进行多变量逻辑回归以调整可能影响两组住院情况的混杂因素。
在2020年11月至2021年5月期间，183例患者接受了巴瑞替尼单抗治疗，270例患者接受了卡西瑞维单抗/依德维单抗治疗。平均年龄约为67岁，体重指数为30kg/m。卡西瑞维单抗/依德维单抗和巴瑞替尼单抗的30天与治疗相关的失败率分别为4.8%和13.7%（P = 0.001）。两种单克隆抗体在症状发作早期（<3天）和晚期给药之间未发现显著差异。
与卡西瑞维单抗/依德维单抗相比，巴瑞替尼单抗的失败率更高。两种单克隆抗体在早期与晚期给药之间未发现疗效差异。
