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
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...
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| Format: | Article |
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PeerJ Inc.
2023-05-01
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| Online Access: | https://peerj.com/articles/15344.pdf |
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| author | Yu-Lin Tai Ming-Dar Lee Hsin Chi Nan-Chang Chiu Wei-Te Lei Shun-Long Weng Lawrence Yu-Min Liu Chung-Chu Chen Shih-Yu Huang Ya-Ning Huang Chien-Yu Lin |
| author_facet | Yu-Lin Tai Ming-Dar Lee Hsin Chi Nan-Chang Chiu Wei-Te Lei Shun-Long Weng Lawrence Yu-Min Liu Chung-Chu Chen Shih-Yu Huang Ya-Ning Huang Chien-Yu Lin |
| author_sort | Yu-Lin Tai |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T06:28:39Z |
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| id | doaj.art-341a5f11202d4035a0b49a06a157474e |
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| language | English |
| last_indexed | 2024-03-09T06:28:39Z |
| publishDate | 2023-05-01 |
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| spelling | doaj.art-341a5f11202d4035a0b49a06a157474e2023-12-03T11:13:14ZengPeerJ Inc.PeerJ2167-83592023-05-0111e1534410.7717/peerj.15344Effects of bamlanivimab alone or in combination with etesevimab on subsequent hospitalization and mortality in outpatients with COVID-19: a systematic review and meta-analysisYu-Lin Tai0Ming-Dar Lee1Hsin Chi2Nan-Chang Chiu3Wei-Te Lei4Shun-Long Weng5Lawrence Yu-Min Liu6Chung-Chu Chen7Shih-Yu Huang8Ya-Ning Huang9Chien-Yu Lin10Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanPediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanMedicine, MacKay Medical College, New Taipei, TaiwanMedicine, MacKay Medical College, New Taipei, TaiwanPediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanMedicine, MacKay Medical College, New Taipei, TaiwanMedicine, MacKay Medical College, New Taipei, TaiwanDepartment of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanDepartment of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanPediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanPediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, TaiwanBackground 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.https://peerj.com/articles/15344.pdfCOVID-19Monoclonal antibodyAnti-viral treatmentBamlanivimabEtesevimab |
| spellingShingle | Yu-Lin Tai Ming-Dar Lee Hsin Chi Nan-Chang Chiu Wei-Te Lei Shun-Long Weng Lawrence Yu-Min Liu Chung-Chu Chen Shih-Yu Huang Ya-Ning Huang Chien-Yu Lin 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 COVID-19 Monoclonal antibody Anti-viral treatment Bamlanivimab Etesevimab |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | COVID-19 Monoclonal antibody Anti-viral treatment Bamlanivimab Etesevimab |
| url | https://peerj.com/articles/15344.pdf |
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