DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20222277
Published: 2022-08-29

Effect of casirivimab-imdevimab on mild COVID-19 patients with diabetes in reducing oxygen supplementation at 28 days: an observational study

Bhagyanath T., Remitha K. R., Akshay C. R., Aswin P., Deepak S., Jithesh R.

Abstract


Background: Monoclonal antibody therapy is one of the most promising treatments for COVID-19 infection. Casirivimab-imdevimab is a monoclonal antibody cocktail which is approved for high-risk patients with mild to moderate COVID-19 infection. The aim of the study was to determine the safety and efficacy of casirivimab-imdevimab on diabetic patients with COVID-19.

Methods: This was an observational study conducted on diabetic patients admitted with mild to moderate COVID-19 infection. The patients were divided into 2 groups. While 101 patients were administered with casirivimab-imdevimab (test group), 100 of them were provided with standard treatment (control group). Regular follow-ups ensued for 10 days during the period of their hospitalization and finally on the 28th day through a telephonic enquiry. Apart from this, safety of administering the drug was assessed in all patients who belonged to the test group.

Results: One of the patients who were administered casirivimab-imdevimab developed anaphylactic reaction. Three fourth of the patients who participated in the study were vaccinated and the oxygen requirement up to 10 days of admission was significantly lower in the vaccinated group (p=0.018). Oxygen requirement, mechanical ventilation and death up to 10 days of admission were less for patients who were administered monoclonal antibody, but it was not statistically significant. Oxygen requirement, and death after 10 days up to 28 days were also less for patients who were administered monoclonal antibody, even though not statistically significant.

Conclusions: Casirivimab-imdevimab was not found to be beneficial in diabetic patients with mild COVID-19. More studies with higher sample size are required to prove the clinical benefit of casirivimab-imdevimab beyond doubt.


Keywords


COVID-19, Diabetes mellitus, Casirivimab, Imdevimab, Monoclonal antibody, Oxygen requirement

Full Text:

PDF

References


WHO. Coronavirus (COVID-19) Dashboard. WHO Coronavirus (COVID-19) Dashboard With Vaccination Data, 2021. Available at: https://covid19. who.int/. Accessed on 01 May 2022.

Baum A, Fulton BO, Wloga E, Copin R, Pascal KE, Russo V, et al. Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies. Science. 2020;369(6506):1014-8.

Casirivimab and Imdevimab. Available at: https://www.regeneron.com/casirivimab-imdevimab. Accessed on 01 May 2022.

U. S. Food and Drug Administration. Coronavirus (COVID-19) Update: FDA Authorizes Monoclonal Antibody for Treatment of COVID-19 | FDA. FDA News Release, 2020. Available at: https://www. fda.gov/newsevents/pressannouncements/coronavirus-covid-19updatefdaauthorizesmonoclonalantibody-treatment-covid-19. Accessed on 01 May 2022.

Roche receives Emergency Use Authorisation in India for its investigational Antibody Cocktail (Casirivimab and Imdevimab) used in the treatment of Covid-19. 2021. Available at: https://www. cipla.com/press-releases-statements/roche-receives-EUA-India-investigational-antibody-cocktail-casirivimab-Imdevimab-covid. Accessed on 01 May 2022.

Gazzaz ZJ. Diabetes and COVID-19. Open Life Sci. 2021;16(1):297-302.

Roche. New phase III data shows investigational antibody cocktail casirivimab and imdevimab reduced hospitalisation or death by 70% in non-hospitalised patients with COVID-19. 2021. Available at: https://www.roche.com/media/releases/ med-cor-2021-03-23.htm. Accessed on 01 May 2022.

Bansode B, Prasad JB. Burden of comorbidities among diabetic patients in Latur, India. Clin Epidemiol Glob Heal. 2022;13.

Wang Z, Deng H, Ou C, Liang J, Wang Y, Jiang M, et al. Clinical symptoms, comorbidities and complications in severe and non-severe patients with COVID-19: A systematic review and meta-analysis without cases duplication. Medicine (Baltimore). 2020;99(48):e23327.

Abani O, Abbas A, Abbas F, Abbas M, Abbasi S, Abbass H, et al. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet (London, England). 2022;399(10325):665-76.

Razonable RR, Pawlowski C, O’Horo JC, Arndt LL, Arndt R, Bierle DM, et al. Casirivimab–Imdevimab treatment is associated with reduced rates of hospitalization among high-risk patients with mild to moderate coronavirus disease-19. eClinical Medicine. 2021;40.

Ganesh R, Philpot LM, Bierle DM, Anderson RJ, Arndt LL, Arndt RF, et al. Real-World Clinical Outcomes of Bamlanivimab and Casirivimab-Imdevimab among High-Risk Patients with Mild to Moderate Coronavirus Disease 2019. J Infect Dis. 2021;224(8):1278-86.

Bierle DM, Ganesh R, Razonable RR. Breakthrough COVID-19 and casirivimab-imdevimab treatment during a SARS-CoV-2 B1.617.2 (Delta) surge. J Clin Virol. 2021;145.

Joy AP, Augustine AT, Karattuthodi MS, Parambil JC, Chandrasekher D, Danisha P, et al. The impact of casirivimab-imdevimab antibody cocktail in patients amidst and post COVID 19 treatment: A retro-prospective comparative study in India. Clin Epidemiol Glob Heal. 2022;14.

Venkitakrishnan R, Augustine J, Ramachandran D, Cleetus M. Casirivimab - Imdevimab in Covid 19 - Early Indian experience. Indian J Tuberc. 2022;69(3):366-8.