The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical Trials
Background: The use of monoclonal antibody as the proposed treatment of COVID-19 showed different results in various prior studies, and Efficacy remains open in literature. This study aimed to comprehensively determine the effect of monoclonal antibodies on clinical, laboratory, and safety outcomes...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Interna Publishing
2023-07-01
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| Series: | Acta Medica Indonesiana |
| Subjects: | |
| Online Access: | https://actamedindones.org/index.php/ijim/article/view/2406 |
| _version_ | 1797642287698673664 |
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| author | Ifan Ali Wafa Nando Reza Pratama David Setyo Budi Henry Sutanto Alfian Nur Rosyid Citrawati Dyah Kencono Wungu |
| author_facet | Ifan Ali Wafa Nando Reza Pratama David Setyo Budi Henry Sutanto Alfian Nur Rosyid Citrawati Dyah Kencono Wungu |
| author_sort | Ifan Ali Wafa |
| collection | DOAJ |
| description | Background: The use of monoclonal antibody as the proposed treatment of COVID-19 showed different results in various prior studies, and Efficacy remains open in literature. This study aimed to comprehensively determine the effect of monoclonal antibodies on clinical, laboratory, and safety outcomes in COVID-19 patients. Methods: Sixteen RCTs were analyzed in this meta-analysis using RevMan 5.4 to measure the pooled estimates of risk ratios (RRs) and standardized mean differences (SMDs) with 95% CIs. Results: The pooled effect of Monoclonal antibodies demonstrated efficacy on mortality risk reduction (RR=0,89 (95%CI 0.82-0.96), I2=13%, fixed-effect), Tocilizumab also show efficacy on mortality risk reduction for severe-critical disease (RR=0.90 (95%CI 0.83-0.97), I2=12%, fixed-effect)), need for mechanical ventilation (RR=0.76 (95%CI 0.62-0.94), I2=42%, random-effects), and hospital discharge (RR=1.07 (95%CI 1.00-1.14), I2=60%, random-effects). Bamlanivimab monotherapy did not reduce viral load (SMD=-0.07 (95%CI -0.21-0.07), I2=44%, fixed-effect). Monoclonal antibodies did not differ from placebo/standard therapy for hospital discharge at day 28-30 (RR=1.05 (95%CI 0.99–1.12), I2=71%, random-effects) and safety (RR=1.04 (95%CI 0.76–1.43), I2=54%, random-effects). Conclusion: Tocilizumab should be used for severe to critical COVID-19 because it is not harmful and can improve mortality risk, mechanical ventilation, and hospital discharge. Bamlanivimab-Etesevimab and REGN-COV2 reduced viral load in mild-moderate outpatients. |
| first_indexed | 2024-03-11T13:57:53Z |
| format | Article |
| id | doaj.art-23a8646c38954409ab42d28d4e5d5282 |
| institution | Directory Open Access Journal |
| issn | 0125-9326 2338-2732 |
| language | English |
| last_indexed | 2024-03-11T13:57:53Z |
| publishDate | 2023-07-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj.art-23a8646c38954409ab42d28d4e5d52822023-11-02T05:29:01ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322023-07-01553599The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical TrialsIfan Ali Wafa0Nando Reza Pratama1David Setyo Budi2Henry Sutanto3Alfian Nur Rosyid4Citrawati Dyah Kencono Wungu5Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaNuffield Department of Medicine, University of Oxford, United KingdomFaculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaPh.D graduate, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, 6211 Maastricht, The NetherlandsDepartment of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaBackground: The use of monoclonal antibody as the proposed treatment of COVID-19 showed different results in various prior studies, and Efficacy remains open in literature. This study aimed to comprehensively determine the effect of monoclonal antibodies on clinical, laboratory, and safety outcomes in COVID-19 patients. Methods: Sixteen RCTs were analyzed in this meta-analysis using RevMan 5.4 to measure the pooled estimates of risk ratios (RRs) and standardized mean differences (SMDs) with 95% CIs. Results: The pooled effect of Monoclonal antibodies demonstrated efficacy on mortality risk reduction (RR=0,89 (95%CI 0.82-0.96), I2=13%, fixed-effect), Tocilizumab also show efficacy on mortality risk reduction for severe-critical disease (RR=0.90 (95%CI 0.83-0.97), I2=12%, fixed-effect)), need for mechanical ventilation (RR=0.76 (95%CI 0.62-0.94), I2=42%, random-effects), and hospital discharge (RR=1.07 (95%CI 1.00-1.14), I2=60%, random-effects). Bamlanivimab monotherapy did not reduce viral load (SMD=-0.07 (95%CI -0.21-0.07), I2=44%, fixed-effect). Monoclonal antibodies did not differ from placebo/standard therapy for hospital discharge at day 28-30 (RR=1.05 (95%CI 0.99–1.12), I2=71%, random-effects) and safety (RR=1.04 (95%CI 0.76–1.43), I2=54%, random-effects). Conclusion: Tocilizumab should be used for severe to critical COVID-19 because it is not harmful and can improve mortality risk, mechanical ventilation, and hospital discharge. Bamlanivimab-Etesevimab and REGN-COV2 reduced viral load in mild-moderate outpatients.https://actamedindones.org/index.php/ijim/article/view/2406covid-19meta-analysismonoclonal antibodymortalityviral load |
| spellingShingle | Ifan Ali Wafa Nando Reza Pratama David Setyo Budi Henry Sutanto Alfian Nur Rosyid Citrawati Dyah Kencono Wungu The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical Trials Acta Medica Indonesiana covid-19 meta-analysis monoclonal antibody mortality viral load |
| title | The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical Trials |
| title_full | The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical Trials |
| title_fullStr | The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical Trials |
| title_full_unstemmed | The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical Trials |
| title_short | The Efficacy and Safety of Monoclonal Antibody Treatments Against COVID-19: A Systematic Review and Meta-analysis of Randomized Clinical Trials |
| title_sort | efficacy and safety of monoclonal antibody treatments against covid 19 a systematic review and meta analysis of randomized clinical trials |
| topic | covid-19 meta-analysis monoclonal antibody mortality viral load |
| url | https://actamedindones.org/index.php/ijim/article/view/2406 |
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