Specialty Pharmacy and Infusion Services, UK HealthCare, Lexington, KY, USA.
Am J Health Syst Pharm. 2023 Jan 24;80(3):130-136. doi: 10.1093/ajhp/zxac305.
To evaluate the success of a clinic for subcutaneous administration of casirivmab and imdevimab (REGEN-COV; Regeneron) for treatment of patients with symptomatic mild to moderate coronavirus disease 2019 (COVID-19) in terms of preventing disease progression and healthcare utilization.
This retrospective single-center, propensity-matched cohort study examined healthcare utilization outcomes for patients who received subcutaneous casirivimab and imdevimab at a pharmacist-led clinic of an academic health system. Eligible patients were treated between August 1, 2021, and January 5, 2022, and were at high risk for COVID-19 disease progression. Treatment patients were propensity matched with high-risk control patients with a diagnosis of COVID-19 in the same timeframe who did not receive casirivimab and imdevimab. Patients were followed for 30 days for collection of data on inpatient admissions, emergency department visits, and mortality. Risk of a 30-day healthcare utilization event was assessed and tested for statistical significance utilizing McNemar's test.
A total of 585 patients who received treatment with subcutaneous casirivimab and imdevimab were matched with 585 patients who did not receive casirivimab and imdevimab therapy. Patients who received casirivimab and imdevimab had significantly lower risk of a 30-day all-cause inpatient admission event than untreated patients (relative risk reduction, 62.4%; P < 0.0001). Treated patients also had a significantly lower risk of 30-day all-cause emergency department visit than untreated subjects (relative risk reduction, 36.5%; P = 0.0021). There were 6 mortality events in the untreated group and no mortality events in the treatment group.
This study provides evidence for the effectiveness of a subcutaneous casirivimab and imdevimab clinic in preventing progression of symptomatic mild to moderate COVID-19.
评估一家诊所为治疗有症状的轻度至中度 2019 冠状病毒病（COVID-19）患者而进行的皮下注射卡司瑞韦单抗和伊德维单抗（REGEN-COV；再生元）的疗效，主要评估其在预防疾病进展和医疗保健利用方面的效果。
本回顾性单中心、倾向评分匹配队列研究，调查了在学术医疗系统的药剂师主导诊所接受皮下注射卡司瑞韦单抗和伊德维单抗治疗的患者的医疗保健利用结果。符合条件的患者在 2021 年 8 月 1 日至 2022 年 1 月 5 日期间接受治疗，他们有发生 COVID-19 疾病进展的高风险。治疗患者与同一时期内患有 COVID-19 但未接受卡司瑞韦单抗和伊德维单抗治疗的高风险对照患者进行倾向评分匹配。患者在 30 天内接受随访，以收集住院、急诊就诊和死亡率数据。使用 McNemar 检验评估并检验 30 天内医疗保健利用事件的风险。
共 585 名接受皮下注射卡司瑞韦单抗和伊德维单抗治疗的患者与 585 名未接受卡司瑞韦单抗和伊德维单抗治疗的患者进行了匹配。与未接受治疗的患者相比，接受卡司瑞韦单抗和伊德维单抗治疗的患者发生 30 天内全因住院事件的风险显著降低（相对风险降低，62.4%；P<0.0001）。治疗组患者发生 30 天内全因急诊就诊的风险也显著低于未治疗组（相对风险降低，36.5%；P=0.0021）。未治疗组有 6 例死亡事件，治疗组无死亡事件。
本研究为皮下注射卡司瑞韦单抗和伊德维单抗诊所预防有症状的轻度至中度 COVID-19 进展提供了有效性证据。
