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SARS-CoV-2 中和抗体在 COVID-19 中的应用:在具有显著合并症的种族多样化患者队列中,巴姆洛单抗与巴姆洛单抗-埃特司韦单抗联合使用的结果。

SARS-CoV-2 neutralizing antibodies for COVID-19: Outcomes for bamlanivimab versus bamlanivimab-etesevimab combination in a racially diverse cohort of patients with significant comorbidities.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA.

School of Medicine, Wayne State University, Detroit, Michigan, USA.

出版信息

J Clin Pharm Ther. 2022 Sep;47(9):1438-1443. doi: 10.1111/jcpt.13694. Epub 2022 May 28.

Abstract

WHAT IS KNOWN AND OBJECTIVE

Anti-spike monoclonal antibodies (MAB) including bamlanivimab (BAM) and bamlanivimab/etesevimab (BAM/E) have shown reduced hospitalization rates for non-severe coronavirus disease 2019 (COVID-19) in clinical trials. Recent data have provided real-world hospitalization rates for high-risk patients treated with BAM, however, data on a similar cohort treated with BAM/E are lacking.

METHODS

This retrospective cohort study evaluated outpatients ≥18 years with laboratory-confirmed mild/moderate COVID-19 who received MAB from 1 December 2020 to 19 April 2021. Use of BAM monotherapy changed to BAM/E combination on 27 March 2021. Primary outcome was overall rate of COVID-19 related-hospitalization, including comparison of hospitalization rates between MAB-formulation groups. Secondary outcomes were 30-day mortality and length of stay (LOS).

RESULTS AND DISCUSSION

The population included 643 patients (BAM and BAM/E); median age was 58 years, 43% were male, median BMI was 33 kg/m , and 24% self-identified as Black. Patients in the BAM/E combination group were significantly younger with higher median BMI and a longer time from symptom onset to infusion. The incidence of 30-day COVID-19 related hospitalization was similar between patients receiving either BAM or BAM/E combination (7.8% and 7.2%, respectively).

WHAT IS NEW AND CONCLUSION

This study represents the first such publication of real-world BAM/E hospitalization outcomes. Hospitalization rates utilizing BAM/E were comparable to BAM in our real-world study.

摘要

已知和目的

抗尖峰单克隆抗体(MAB)包括巴姆单抗(BAM)和巴姆单抗/埃特塞韦单抗(BAM/E),在临床试验中显示可降低非重症 2019 年冠状病毒病(COVID-19)的住院率。最近的数据提供了高危患者接受 BAM 治疗的真实世界住院率,但缺乏类似队列接受 BAM/E 治疗的数据。

方法

本回顾性队列研究评估了 2020 年 12 月 1 日至 2021 年 4 月 19 日期间接受 MAB 的实验室确诊为轻度/中度 COVID-19 的年龄≥18 岁的门诊患者。自 2021 年 3 月 27 日起,BAM 单药治疗改为 BAM/E 联合治疗。主要结局是 COVID-19 相关住院的总体发生率,包括比较两种 MAB 制剂组的住院率。次要结局为 30 天死亡率和住院时间(LOS)。

结果和讨论

该人群包括 643 例患者(BAM 和 BAM/E);中位年龄为 58 岁,43%为男性,中位 BMI 为 33kg/m ,24%自我认定为黑人。BAM/E 联合组的患者年龄明显较小,BMI 中位数较高,从症状出现到输注的时间较长。接受 BAM 或 BAM/E 联合治疗的患者 30 天 COVID-19 相关住院的发生率相似(分别为 7.8%和 7.2%)。

新发现和结论

本研究是首次发表关于 BAM/E 真实世界住院结局的研究。在我们的真实世界研究中,BAM/E 的住院率与 BAM 相当。

相似文献

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Bamlanivimab plus Etesevimab in Mild or Moderate Covid-19.巴尼韦单抗/依特司韦单抗在轻中度 COVID-19 中的应用。
N Engl J Med. 2021 Oct 7;385(15):1382-1392. doi: 10.1056/NEJMoa2102685. Epub 2021 Jul 14.

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