Int J Med Sci 2022; 19(5):834-841. doi:10.7150/ijms.71132 This issue

Research Paper

Real-world clinical outcomes of treatment with casirivimab-imdevimab among patients with mild-to-moderate coronavirus disease 2019 during the Delta variant pandemic

Yasuhito Suzuki1, Yoko Shibata1, Hiroyuki Minemura1, Takefumi Nikaido1,2, Yoshinori Tanino1, Atsuro Fukuhara1,9, Ryuzo Kanno3, Hiroyuki Saito4, Shuzo Suzuki4, Taeko Ishii5, Yayoi Inokoshi5, Eiichiro Sando6, Hirofumi Sakuma7, Tatsuho Kobayashi8, Hiroaki Kume9, Masahiro Kamimoto10, Hideko Aoki11, Akira Takama12, Takamichi Kamiyama13, Masaru Nakayama14, Kiyoshi Saito15, Koichi Tanigawa16, Masahiko Sato17, Toshiyuki Kanbe18, Norio Kanzaki19, Teruhisa Azuma20, Keiji Sakamoto21, Yuichi Nakamura21, Hiroshi Ohtani22, Mitsuru Waragai23, Shinsaku Maeda24, Tokiya Ishida25, Keishi Sugino26, Yasuhiko Tsukada27, Ryuki Yamada1, Riko Sato1, Takumi Onuma1, Hikaru Tomita1, Mikako Saito1, Natsumi Watanabe1, Mami Rikimaru1, Takaya Kawamata1, Takashi Umeda1, Julia Morimoto1, Ryuichi Togawa1, Yuki Sato1, Junpei Saito1, Kenya Kanazawa1, Ken Iseki27✉

1. Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan
2. Department of Pulmonary Medicine, Ohara General Hospital, Fukushima, Japan
3. Department of Thoracic Surgery, Fukushima Red Cross Hospital, Fukushima, Japan
4. Department of Internal Medicine, Fujita General Hospital, Fukushima, Japan
5. Department of Pulmonary Medicine, Saiseikai Fukushima General Hospital, Fukushima, Japan
6. Department of General Internal Medicine and Clinical Infectious Diseases, Fukushima Medical University, Fukushima, Japan
7. Department of Internal Medicine, Saiseikai Kawamata Hospital, Fukushima, Japan
8. Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, Fukushima, Japan
9. Department of Infectious Disease and Pulmonary Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
10. Department of Internal Medicine, Takeda General Hospital, Fukushima, Japan
11. Department of Pediatric Medicine, Bange Kousei General Hospital, Fukushima, Japan
12. Department of Surgery, Yurin Hospital, Fukushima, Japan
13. Department of Pediatric Surgery, Iwaki City Medical Center, Fukushima, Japan
14. Department of Internal Medicine, Kashima Hospital, Fukushima, Japan
15. Department of Neurosurgery, Fukushima Rosai Hospital, Fukushima, Japan
16. Department of Emergency and Critical Care Medicine, Futaba Medical Center, Fukushima, Japan
17. Department of Internal Medicine, Soma General Hospital, Fukushima, Japan
18. Department of Pulmonary Medicine, Minami-Soma Municipal General Hospital, Fukushima, Japan
19. Department of Surgery, Onahama Chuo Clinic, Fukushima, Japan
20. Department of General Medicine, Shirakawa Satellite for Teaching and Research, Fukushima Medical University, Fukushima, Japan
21. Department of Cardiology and Vascular Medicine, Hoshi General Hospital, Fukushima, Japan
22. Department of Internal Medicine, Iwase General Hospital, Sukagawa, Japan
23. Department of Surgery, Southern TOHOKU General Hospital, Fukushima, Japan
24. Department of Pulmonary Medicine, Jusendo General Hospital, Fukushima, Japan
25. Department of Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, Fukushima, Japan
26. Department of Respiratory Medicine, Tsuboi Hospital, Fukushima, Japan
27. Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima, Japan

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Citation:
Suzuki Y, Shibata Y, Minemura H, Nikaido T, Tanino Y, Fukuhara A, Kanno R, Saito H, Suzuki S, Ishii T, Inokoshi Y, Sando E, Sakuma H, Kobayashi T, Kume H, Kamimoto M, Aoki H, Takama A, Kamiyama T, Nakayama M, Saito K, Tanigawa K, Sato M, Kanbe T, Kanzaki N, Azuma T, Sakamoto K, Nakamura Y, Ohtani H, Waragai M, Maeda S, Ishida T, Sugino K, Tsukada Y, Yamada R, Sato R, Onuma T, Tomita H, Saito M, Watanabe N, Rikimaru M, Kawamata T, Umeda T, Morimoto J, Togawa R, Sato Y, Saito J, Kanazawa K, Iseki K. Real-world clinical outcomes of treatment with casirivimab-imdevimab among patients with mild-to-moderate coronavirus disease 2019 during the Delta variant pandemic. Int J Med Sci 2022; 19(5):834-841. doi:10.7150/ijms.71132. Available from https://www.medsci.org/v19p0834.htm

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Abstract

Graphic abstract

Background: Mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may reduce the efficacy of neutralizing monoclonal antibody therapy against coronavirus disease 2019 (COVID-19). We here evaluated the efficacy of casirivimab-imdevimab in patients with mild-to-moderate COVID-19 during the Delta variant surge in Fukushima Prefecture, Japan.

Methods: We enrolled 949 patients with mild-to-moderate COVID-19 who were admitted to hospital between July 24, 2021 and September 30, 2021. Clinical deterioration after admission was compared between casirivimab-imdevimab users (n = 314) and non-users (n = 635).

Results: The casirivimab-imdevimab users were older (P < 0.0001), had higher body temperature (≥ 38°C) (P < 0.0001) and greater rates of history of cigarette smoking (P = 0.0068), hypertension (P = 0.0004), obesity (P < 0.0001), and dyslipidemia (P < 0.0001) than the non-users. Multivariate logistic regression analysis demonstrated that receiving casirivimab-imdevimab was an independent factor for preventing deterioration (odds ratio 0.448; 95% confidence interval 0.263-0.763; P = 0.0023). Furthermore, in 222 patients who were selected from each group after matching on the propensity score, deterioration was significantly lower among those receiving casirivimab-imdevimab compared to those not receiving casirivimab-imdevimab (7.66% vs 14.0%; p = 0.021).

Conclusion: This real-world study demonstrates that casirivimab-imdevimab contributes to the prevention of deterioration in COVID-19 patients after hospitalization during a Delta variant surge.

Keywords: casirivimab-imdevimab, COVID-19, SARS-CoV-2, Delta variant, real-world effectiveness