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.
PeerJ
; 11: e15344, 2023.
Article
in English
| MEDLINE | ID: covidwho-2319728
ABSTRACT
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], I2 69%; p < 0.01) and mortality (15 trials, OR 0.27, 95% CI [0.17-0.43], I2 0%; p = 0.85). Bamlanivimab monotherapy also reduced the subsequent risk of hospitalization (16 trials, OR 0.43, 95% CI [0.34-0.54], I2 57%; p = 0.01) and mortality (14 trials, OR 0.28, 95% CI [0.17-0.46], I2 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
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Outpatients
/
COVID-19
Type of study:
Experimental Studies
/
Prognostic study
/
Qualitative research
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Variants
Limits:
Humans
Language:
English
Journal:
PeerJ
Year:
2023
Document Type:
Article
Affiliation country:
Peerj.15344
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