tetano
Editor, Senior Moderator
PeerJ
. 2023 May 8;11:e15344.
doi: 10.7717/peerj.15344. eCollection 2023. Effects of bamlanivimab alone or in combination with etesevimab on subsequent hospitalization and mortality in outpatients with COVID-19: a systematic review and meta-analysis
Yu-Lin Tai[SUP] #[/SUP][SUP] 1 2 [/SUP], Ming-Dar Lee[SUP] #[/SUP][SUP] 1 2 [/SUP], Hsin Chi[SUP] 3 4 [/SUP], Nan-Chang Chiu[SUP] 3 4 [/SUP], Wei-Te Lei[SUP] 1 2 5 [/SUP], Shun-Long Weng[SUP] 3 6 [/SUP], Lawrence Yu-Min Liu[SUP] 3 7 [/SUP], Chung-Chu Chen[SUP] 7 8 [/SUP], Shih-Yu Huang[SUP] 7 [/SUP], Ya-Ning Huang[SUP] 1 2 [/SUP], Chien-Yu Lin[SUP] 1 2 3 [/SUP]
Affiliations
Background: 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.
Methods: 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.
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], I[SUP]2[/SUP]: 69%; p < 0.01) and mortality (15 trials, OR: 0.27, 95% CI [0.17-0.43], I[SUP]2[/SUP]: 0%; p = 0.85). Bamlanivimab monotherapy also reduced the subsequent risk of hospitalization (16 trials, OR: 0.43, 95% CI [0.34-0.54], I[SUP]2[/SUP]: 57%; p = 0.01) and mortality (14 trials, OR: 0.28, 95% CI [0.17-0.46], I[SUP]2[/SUP]: 0%; p = 0.9). Adverse events from these medications were uncommon and tolerable.
Conclusions: 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.
Keywords: Anti-viral treatment; Bamlanivimab; COVID-19; Etesevimab; Monoclonal antibody.
. 2023 May 8;11:e15344.
doi: 10.7717/peerj.15344. eCollection 2023. Effects of bamlanivimab alone or in combination with etesevimab on subsequent hospitalization and mortality in outpatients with COVID-19: a systematic review and meta-analysis
Yu-Lin Tai[SUP] #[/SUP][SUP] 1 2 [/SUP], Ming-Dar Lee[SUP] #[/SUP][SUP] 1 2 [/SUP], Hsin Chi[SUP] 3 4 [/SUP], Nan-Chang Chiu[SUP] 3 4 [/SUP], Wei-Te Lei[SUP] 1 2 5 [/SUP], Shun-Long Weng[SUP] 3 6 [/SUP], Lawrence Yu-Min Liu[SUP] 3 7 [/SUP], Chung-Chu Chen[SUP] 7 8 [/SUP], Shih-Yu Huang[SUP] 7 [/SUP], Ya-Ning Huang[SUP] 1 2 [/SUP], Chien-Yu Lin[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 37180576
- PMCID: PMC10174063
- DOI: 10.7717/peerj.15344
Background: 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.
Methods: 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.
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], I[SUP]2[/SUP]: 69%; p < 0.01) and mortality (15 trials, OR: 0.27, 95% CI [0.17-0.43], I[SUP]2[/SUP]: 0%; p = 0.85). Bamlanivimab monotherapy also reduced the subsequent risk of hospitalization (16 trials, OR: 0.43, 95% CI [0.34-0.54], I[SUP]2[/SUP]: 57%; p = 0.01) and mortality (14 trials, OR: 0.28, 95% CI [0.17-0.46], I[SUP]2[/SUP]: 0%; p = 0.9). Adverse events from these medications were uncommon and tolerable.
Conclusions: 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.
Keywords: Anti-viral treatment; Bamlanivimab; COVID-19; Etesevimab; Monoclonal antibody.