Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.
Pediatrics, Hsinchu Municipal MacKay Children's Hospital, Hsinchu, Taiwan.
PeerJ. 2023 May 8;11:e15344. doi: 10.7717/peerj.15344. eCollection 2023.
Coronavirus disease 2019 (COVID-19) has caused an enormous loss of life worldwide. The spike protein of the severe acute respiratory syndrome coronavirus 2 is the cause of its virulence. Bamlanivimab, a recombinant monoclonal antibody, has been used alone or in combination with etesevimab to provide passive immunity and improve clinical outcomes. A systematic review and meta-analysis was conducted to investigate the therapeutic effects of bamlanivimab with or without etesevimab (BAM/ETE) treatment.
Our study was registered in PROSPERO (registry number CRD42021270206). We searched the following electronic databases, without language restrictions, until January 2023: PubMed, Embase, medRxiv, and the Cochrane database. A systematic review and meta-analysis was conducted based on the search results.
Eighteen publications with a total of 28,577 patients were identified. Non-hospitalized patients given bamlanivimab with or without etesevimab had a significantly lower risk of subsequent hospitalization (18 trials, odds ratio (OR): 0.37, 95% confidence interval (CI): [0.29-0.49], : 69%; < 0.01) and mortality (15 trials, OR: 0.27, 95% CI [0.17-0.43], : 0%; = 0.85). Bamlanivimab monotherapy also reduced the subsequent risk of hospitalization (16 trials, OR: 0.43, 95% CI [0.34-0.54], : 57%; = 0.01) and mortality (14 trials, OR: 0.28, 95% CI [0.17-0.46], : 0%; = 0.9). Adverse events from these medications were uncommon and tolerable.
In this meta-analysis, we found the use of bamlanivimab with or without etesevimab contributed to a significantly-reduced risk of subsequent hospitalization and mortality in non-hospitalized COVID-19 patients. However, resistance to monoclonal antibodies was observed in COVID-19 variants, resulting in the halting of the clinical use of BAM/ETE. Clinicians' experiences with BAM/ETE indicate the importance of genomic surveillance. BAM/ETE may be repurposed as a potential component of a cocktail regimen in treating future COVID variants.
2019 年冠状病毒病（COVID-19）在全球范围内造成了巨大的生命损失。严重急性呼吸系统综合征冠状病毒 2 的刺突蛋白是其毒力的原因。Bamlanivimab 是一种重组单克隆抗体，已被单独或与etesevimab 联合用于提供被动免疫并改善临床结果。我们进行了一项系统评价和荟萃分析，以研究 Bamlanivimab 联合或不联合etesevimab（BAM/ETE）治疗的治疗效果。
我们的研究已在 PROSPERO（注册号 CRD42021270206）中注册。我们在不限制语言的情况下，检索了以下电子数据库，直到 2023 年 1 月：PubMed、Embase、medRxiv 和 Cochrane 数据库。根据检索结果进行了系统评价和荟萃分析。
确定了 18 项共 28577 名患者的出版物。接受 Bamlanivimab 联合或不联合etesevimab 的非住院患者随后住院的风险显著降低（18 项试验，比值比（OR）：0.37，95%置信区间（CI）：[0.29-0.49]， ：69%； < 0.01）和死亡率（15 项试验，OR：0.27，95% CI：[0.17-0.43]， ：0%； = 0.85）。Bamlanivimab 单药治疗也降低了随后住院的风险（16 项试验，OR：0.43，95% CI：[0.34-0.54]， ：57%； = 0.01）和死亡率（14 项试验，OR：0.28，95% CI：[0.17-0.46]， ：0%； = 0.9）。这些药物的不良反应并不常见且可耐受。
在这项荟萃分析中，我们发现使用 Bamlanivimab 联合或不联合etesevimab 可显著降低非住院 COVID-19 患者随后住院和死亡的风险。然而，在 COVID-19 变体中观察到了对单克隆抗体的耐药性，导致 BAM/ETE 的临床应用停止。临床医生使用 BAM/ETE 的经验表明了基因组监测的重要性。BAM/ETE 可能被重新用作治疗未来 COVID 变体鸡尾酒疗法的潜在成分。
