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Subcutaneous REGEN-COV Antibody Combination in Early SARS-CoV-2 Infection.


ABSTRACT:

Background

Casirivimab and imdevimab administered together (REGEN-COV™) markedly reduces the risk of hospitalization or death in high-risk, symptomatic individuals with COVID-19. Here, we report phase 3 results of early treatment of asymptomatic, SARS-CoV-2-positive adults and adolescents with subcutaneous REGEN-COV.

Methods

Individuals ≥12 years of age were eligible if identified within 96 hours of a household contact being diagnosed as SARS-CoV-2-positive; 314 were randomized 1:1 to receive subcutaneous REGEN-COV 1200mg or placebo. The primary endpoint was the proportion of infected participants without evidence of prior immunity (i.e., SARS-CoV-2-RT-qPCR-positive/seronegative) who subsequently developed symptomatic Covid-19 during a 28-day efficacy assessment period.

Results

Subcutaneous REGEN-COV 1200mg significantly prevented progression from asymptomatic to symptomatic disease compared with placebo (31.5% relative risk reduction; 29/100 [29.0%] vs. 44/104 [42.3%], respectively; P=0.0380). REGEN-COV also reduced the overall population burden of high viral load weeks (39.7% reduction vs. placebo; 48 vs. 82 total weeks; P=0.0010) and of symptomatic weeks (45.3% reduction vs. placebo; 89.6 vs. 170.3 total weeks; P=0.0273), the latter corresponding to an approximately 5.6-day reduction per symptomatic participant. Six placebo-treated participants had a Covid-19-related hospitalization or ER visit versus none for those receiving REGEN-COV. The proportion of participants receiving placebo who had ≥1 treatment-emergent adverse events was 48.1% compared to 33.5% for those receiving REGEN-COV, including Covid-19-related (39.7% vs. 25.8%, respectively) or non-Covid-19-related (16.0% vs. 11.0%, respectively) events.

Conclusions

Subcutaneous REGEN-COV 1200mg prevented progression from asymptomatic to symptomatic infection, reduced the duration of high viral load and symptoms, and was well tolerated.(ClinicalTrials.gov number, NCT04452318.).

SUBMITTER: O'Brien MP 

PROVIDER: S-EPMC8219113 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

Subcutaneous REGEN-COV Antibody Combination in Early Asymptomatic SARS-CoV-2 Infection: A Randomized Clinical Trial.

O'Brien Meagan P MP   Forleo-Neto Eduardo E   Sarkar Neena N   Isa Flonza F   Hou Peijie P   Chan Kuo-Chen KC   Musser Bret J BJ   Bar Katharine J KJ   Barnabas Ruanne V RV   Barouch Dan H DH   Cohen Myron S MS   Hurt Christopher B CB   Burwen Dale R DR   Marovich Mary A MA   Brown Elizabeth R ER   Heirman Ingeborg I   Davis John D JD   Turner Kenneth C KC   Ramesh Divya D   Mahmood Adnan A   Hooper Andrea T AT   Hamilton Jennifer D JD   Kim Yunji Y   Purcell Lisa A LA   Baum Alina A   Kyratsous Christos A CA   Krainson James J   Perez-Perez Richard R   Mohseni Rizwana R   Kowal Bari B   DiCioccio A Thomas AT   Stahl Neil N   Lipsich Leah L   Braunstein Ned N   Herman Gary G   Yancopoulos George D GD   Weinreich David M DM  

medRxiv : the preprint server for health sciences 20210918


<h4>Importance</h4>Easy-to-administer antiviral treatments may be used to prevent progression from asymptomatic infection to COVID-19 and to reduce viral carriage.<h4>Objective</h4>Evaluate the efficacy and safety of subcutaneous casirivimab and imdevimab antibody combination (REGEN-COV) to prevent progression from early asymptomatic SARS-CoV-2 infection to COVID-19.<h4>Design</h4>Randomized, double-blind, placebo-controlled, phase 3 study that enrolled asymptomatic close contacts living with a  ...[more]

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