Cui Zhifang, Wang Hongwu, Zou Heng, Li Lei, Zhang Ye, Chen Wenyu
Department of Respiratory Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China.
J Thorac Dis. 2024 Jun 30;16(6):3606-3622. doi: 10.21037/jtd-23-1604. Epub 2024 Jun 11.
The ongoing global epidemic of coronavirus disease 2019 (COVID-19) has created a serious public health problem. The selection of safe and effective therapeutic agents is of paramount importance. This systematic review aims to evaluate the efficacy and safety of the combination of casirivimab and imdevimab in the treatment of global cases of COVID-19.
To identify randomized controlled trials (RCTs) investigating the combined administration of casirivimab and imdevimab for COVID-19 management, a comprehensive search was conducted across multiple databases including PubMed, Web of Science, Embase, and the Cochrane Library from their inception to September 10, 2022. Data on the efficacy and safety of casirivimab and imdevimab were extracted. Subgroup analyses and sensitivity analyses were performed.
A total of 851 articles were searched. Twelve studies were finally included in the meta-analysis, with 27,179 participants. Dichotomous and continuous variables were presented as odds ratios (ORs) and weighted mean differences (WMDs) with their 95% confidence intervals (CIs), respectively. Compared to placebo or alternative medications, the combination of casirivimab and imdevimab reduced viral load (WMD: -0.73, 95% CI: -1.09 to -0.38, P<0.01), all-cause mortality (OR =0.90, 95% CI: 0.82-0.99, P=0.03), the incidence of any serious adverse events (OR =0.80, 95% CI: 0.67-0.95, P=0.01), the incidence of Grade 3 or more severe adverse events (OR =0.76, 95% CI: 0.62-0.92, P=0.01), the likelihood of contracting COVID-19, the incidence of hospitalization, emergency room visits, and mortality (OR =0.54, 95% CI: 0.32-0.93, P=0.03).
The monoclonal antibody combination of casirivimab and imdevimab is effective in treating patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as they can reduce viral load, all-cause mortality, infection rates, and the incidence of clinical outcomes of special interest after treatment, while maintaining a favorable safety profile.
2019冠状病毒病（COVID-19）在全球持续流行，造成了严重的公共卫生问题。选择安全有效的治疗药物至关重要。本系统评价旨在评估卡西瑞维单抗和英地维单抗联合治疗全球COVID-19病例的疗效和安全性。
为了识别研究卡西瑞维单抗和英地维单抗联合用于COVID-19治疗的随机对照试验（RCT），我们对多个数据库进行了全面检索，包括PubMed、科学网、Embase和考克兰图书馆，检索时间从各数据库建库至2022年9月10日。提取了关于卡西瑞维单抗和英地维单抗疗效和安全性的数据。进行了亚组分析和敏感性分析。
共检索到851篇文章。最终有12项研究纳入荟萃分析，涉及27179名参与者。二分变量和连续变量分别以比值比（OR）和加权平均差（WMD）及其95%置信区间（CI）表示。与安慰剂或其他药物相比，卡西瑞维单抗和英地维单抗联合使用可降低病毒载量（WMD：-0.73，95%CI：-1.09至-0.38，P<0.01）、全因死亡率（OR =0.90，95%CI：0.82-0.99，P=0.03）、任何严重不良事件的发生率（OR =0.80，95%CI：0.67-0.95，P=0.01）、3级或更严重不良事件的发生率（OR =0.76，95%CI：0.62-0.92，P=0.01）、感染COVID-19 的可能性、住院率、急诊就诊率和死亡率（OR =0.54，95%CI：0.32-0.93，P=0.03）。
卡西瑞维单抗和英地维单抗的单克隆抗体组合在治疗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者方面是有效的，因为它们可以降低病毒载量、全因死亡率、感染率以及治疗后特殊关注的临床结局的发生率，同时保持良好的安全性。
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