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Real-World Effectiveness and Tolerability of Monoclonal Antibody Therapy for Ambulatory Patients With Early COVID-19

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This is an abstract. The full journal study is available to read via the link in the source information below.

Background

Neutralizing monoclonal antibodies (MAbs) are a promising therapy for early COVID-19, but their effectiveness has not been confirmed in a real-world setting.

Methods

In this quasi-experimental pre-/post-implementation study, we estimated the effectiveness of MAb treatment within 7 days of symptom onset in high-risk ambulatory adults with COVID-19. The primary outcome was a composite of emergency department visits or hospitalizations within 14 days of positive test. Secondary outcomes included adverse events and 14-day mortality. The average treatment effect in the treated for MAb therapy was estimated using inverse probability of treatment weighting and the impact of MAb implementation using propensity-weighted interrupted time series analysis.

Results

Pre-implementation (July-November 2020), 7,404 qualifying patients were identified. Post-implementation (December 2020-January 2021), 594 patients received MAb treatment and 5,536 did not. The primary outcome occurred in 75 (12.6%) MAb recipients, 1,018 (18.4%) contemporaneous controls, and 1,525 (20.6%) historical controls. MAb treatment was associated with decreased likelihood of emergency care or hospitalization (odds ratio 0.69, 95% CI 0.60-0.79). After implementation, the weighted probability that a given patient would require an emergency department visit or hospitalization decreased significantly (0.7% per day, 95% CI 0.03%-0.10%). Mortality was 0.2% (n = 1) in the MAb group compared with 1.0% (n = 71) and 1.0% (n = 57) in pre- and post-implementation controls, respectively. Adverse events occurred in seven patients (1.2%); two (0.3%) were considered serious.

Conclusions

MAb treatment of high-risk ambulatory patients with early COVID-19 was well tolerated and likely effective at preventing the need for subsequent emergency department or hospital care.

Read an interview about the study here.

The full text of this study can be accessed via the source information below.

Last updated

Primary Source

Open Forum Infectious Diseases

Source Reference:

IDSA Publications Corner

IDSA Publications Corner