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Casirivimab/imdevimab for COVID-19: real-time meta analysis of 24 studies
Covid Analysis, September 30, 2022, DRAFT
https://c19early.com/rmeta.html
 
0 0.5 1 1.5+ All studies 56% 24 48,169 Improvement, Studies, Patients Relative Risk Mortality 40% 8 32,929 Ventilation -1% 3 10,248 ICU admission 53% 3 9,896 Hospitalization 48% 11 39,822 Progression 56% 3 680 Recovery 33% 5 8,277 Cases 80% 4 3,265 Viral clearance 55% 2 1,709 RCTs 61% 9 21,306 RCT mortality 20% 3 15,162 Peer-reviewed 42% 14 33,029 Prophylaxis 93% 3 3,061 Early 51% 18 32,170 Late 33% 3 12,938 Casirivimab/imdevimab for COVID-19 c19early.com/r Sep 2022 Favorscasirivimab/im.. Favorscontrol after exclusions
Statistically significant improvements are seen for mortality, hospitalization, progression, recovery, cases, and viral clearance. 17 studies from 12 independent teams in 4 different countries show statistically significant improvements in isolation (7 for the most serious outcome).
Meta analysis using the most serious outcome reported shows 56% [37‑69%] improvement. Results are similar for Randomized Controlled Trials, similar after exclusions, and slightly worse for peer-reviewed studies. Results are consistent with early treatment being more effective than late treatment.
Results are robust — in exclusion sensitivity analysis 13 of 24 studies must be excluded to avoid finding statistically significant efficacy in pooled analysis.
0 0.5 1 1.5+ All studies 56% 24 48,169 Improvement, Studies, Patients Relative Risk Mortality 40% 8 32,929 Ventilation -1% 3 10,248 ICU admission 53% 3 9,896 Hospitalization 48% 11 39,822 Progression 56% 3 680 Recovery 33% 5 8,277 Cases 80% 4 3,265 Viral clearance 55% 2 1,709 RCTs 61% 9 21,306 RCT mortality 20% 3 15,162 Peer-reviewed 42% 14 33,029 Prophylaxis 93% 3 3,061 Early 51% 18 32,170 Late 33% 3 12,938 Casirivimab/imdevimab for COVID-19 c19early.com/r Sep 2022 Favorscasirivimab/im.. Favorscontrol after exclusions
Efficacy is variant dependent. In Vitro studies suggest a lack of efficacy for omicron [Liu, Sheward, Tatham, VanBlargan]. Monoclonal antibody use with variants can be associated with prolonged viral loads, clinical deterioration, and immune escape [Choudhary].
No treatment, vaccine, or intervention is 100% effective and available. All practical, effective, and safe means should be used based on risk/benefit analysis. Multiple treatments are typically used in combination, and other treatments may be more effective. Only 29% of casirivimab/imdevimab studies show zero events with treatment.
All data to reproduce this paper and sources are in the appendix.
Highlights
Casirivimab/imdevimab reduces risk for COVID-19 with very high confidence for hospitalization, progression, recovery, and in pooled analysis, high confidence for mortality and ICU admission, and low confidence for cases and viral clearance. Efficacy is variant dependent. In Vitro research suggests a lack of efficacy for omicron.
We show traditional outcome specific analyses and combined evidence from all studies, incorporating treatment delay, a primary confounding factor in COVID-19 studies.
Real-time updates and corrections, transparent analysis with all results in the same format, consistent protocol for 47 treatments.
A
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Regeneron (RCT) 38% 0.62 [0.29-1.33] recov. time 92 (n) 91 (n) Improvement, RR [CI] Treatment Control Regeneron (RCT) 71% 0.29 [0.17-0.48] death/hosp. 18/1,355 62/1,341 Weinreich (RCT) 50% 0.50 [0.09-2.72] death 2/2,091 4/2,089 Webb 98% 0.0 [0.00-2e+04] death 0/115 57/5,536 Cooper 77% 0.23 [0.03-1.65] death 1/1,148 33/8,534 Kakinoki 58% 0.42 [0.17-0.92] progression 13/55 22/53 Komagamine 77% 0.23 [0.01-4.63] ventilation 0/53 2/75 Suzuki (PSM) -200% 3.00 [0.12-73.3] death 1/222 0/222 O'Brien (DB RCT) 85% 0.15 [0.01-2.78] hosp. 0/100 3/104 Shopen -46% 1.46 [0.73-2.67] severe case 24/116 26/243 Osugi 24% 0.76 [0.23-2.49] hosp. 4/30 15/74 Wei 61% 0.39 [0.26-0.60] death/hosp. 23/1,116 27/5,291 Wilden 82% 0.18 [0.05-0.50] hosp. n/a n/a Faraone 92% 0.08 [0.00-1.24] death 0/11 8/23 Miyashita 33% 0.67 [0.11-3.97] ventilation 2/461 3/461 Levey 31% 0.69 [0.07-7.37] ICU 1/36 2/50 Kneidinger 97% 0.0 [0.00-1e+04] severe case 0/3 34/215 Williams -21% 1.21 [0.14-9.86] oxygen 1/88 6/676 Tau​2 = 0.24, I​2 = 47.0%, p = 0.00039 Early treatment 51% 0.49 [0.33-0.72] 90/7,092 304/25,078 51% improvement Horby (RCT) 6% 0.94 [0.86-1.02] death 943/4,839 1,029/4,946 Improvement, RR [CI] Treatment Control Somersa.. (DB RCT) 36% 0.64 [0.44-0.93] death 59/804 45/393 McCreary (PSM) 93% 0.07 [0.01-0.51] death 1/652 29/1,304 Tau​2 = 0.15, I​2 = 80.8%, p = 0.16 Late treatment 33% 0.67 [0.39-1.17] 1,003/6,295 1,103/6,643 33% improvement Regeneron (RCT) 94% 0.06 [0.00-1.10] symp. case 0/186 8/223 Improvement, RR [CI] Treatment Control Regeneron (DB RCT) 92% 0.08 [0.00-1.36] hosp. 0/841 6/842 Isa (DB RCT) 93% 0.07 [0.01-0.28] symp. case 3/729 13/240 Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Prophylaxis 93% 0.07 [0.03-0.21] 3/1,756 27/1,305 93% improvement All studies 56% 0.44 [0.31-0.63] 1,096/15,143 1,434/33,026 56% improvement 24 casirivimab/imdevimab COVID-19 studies c19early.com/r Sep 2022 Tau​2 = 0.32, I​2 = 73.1%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) Favors casirivimab/im.. Favors control
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Regeneron (RCT) 38% recovery Improvement Relative Risk [CI] Regeneron (RCT) 71% death/hosp. Weinreich (RCT) 50% death Webb 98% death Cooper 77% death Kakinoki 58% progression Komagamine 77% ventilation Suzuki (PSM) -200% death O'Brien (DB RCT) 85% hospitalization Shopen -46% severe case Osugi 24% hospitalization Wei 61% death/hosp. Wilden 82% hospitalization Faraone 92% death Miyashita 33% ventilation Levey 31% ICU admission Kneidinger 97% severe case Williams -21% oxygen therapy Tau​2 = 0.24, I​2 = 47.0%, p = 0.00039 Early treatment 51% 51% improvement Horby (RCT) 6% death Somersa.. (DB RCT) 36% death McCreary (PSM) 93% death Tau​2 = 0.15, I​2 = 80.8%, p = 0.16 Late treatment 33% 33% improvement Regeneron (RCT) 94% symp. case Regeneron (DB RCT) 92% hospitalization Isa (DB RCT) 93% symp. case Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Prophylaxis 93% 93% improvement All studies 56% 56% improvement 24 casirivimab/imdevimab COVID-19 studies c19early.com/r Sep 2022 Tau​2 = 0.32, I​2 = 73.1%, p < 0.0001 Effect extraction pre-specifiedRotate device for details Favors casirivimab/im.. Favors control
Figure 1. A. Random effects meta-analysis. This plot shows pooled effects, discussion can be found in the heterogeneity section, and results for specific outcomes can be found in the individual outcome analyses. Effect extraction is pre-specified, using the most serious outcome reported. For details of effect extraction see the appendix. B. Scatter plot showing the distribution of effects reported in studies. C. History of all reported effects (chronological within treatment stages).
Introduction
We analyze all significant studies concerning the use of casirivimab/imdevimab for COVID-19. Search methods, inclusion criteria, effect extraction criteria (more serious outcomes have priority), all individual study data, PRISMA answers, and statistical methods are detailed in Appendix 1. We present random effects meta-analysis results for all studies, for studies within each treatment stage, for individual outcomes, for peer-reviewed studies, for Randomized Controlled Trials (RCTs), and after exclusions.
Figure 2 shows stages of possible treatment for COVID-19. Prophylaxis refers to regularly taking medication before becoming sick, in order to prevent or minimize infection. Early Treatment refers to treatment immediately or soon after symptoms appear, while Late Treatment refers to more delayed treatment.
Figure 2. Treatment stages.
Variant Dependence
Efficacy is variant dependent, for example in vitro studies suggest that casirivimab/imdevimab is not effective for the omicron variant [Liu, Sheward, Tatham, VanBlargan, Zhou].
Results
Figure 3 shows a visual overview of the results, with details in Table 1 and Table 2. Figure 4, 5, 6, 7, 8, 9, 10, 11, 12, and 13 show forest plots for a random effects meta-analysis of all studies with pooled effects, mortality results, ventilation, ICU admission, hospitalization, progression, recovery, cases, viral clearance, and peer reviewed studies.
0 0.5 1 1.5+ ALL STUDIES MORTALITY VENTILATION ICU ADMISSION HOSPITALIZATION PROGRESSION RECOVERY CASES VIRAL CLEARANCE RANDOMIZED CONTROLLED TRIALS RCT MORTALITY PEER-REVIEWED After Exclusions ALL STUDIES All Prophylaxis Early Late Casirivimab/imdevimab for COVID-19 C19EARLY.COM/R SEP 2022
Figure 3. Overview of results.
Treatment timeNumber of studies reporting positive effects Total number of studiesPercentage of studies reporting positive effects Random effects meta-analysis results
Early treatment 15 18 83.3% 51% improvement
RR 0.49 [0.33‑0.72]
p = 0.00039
Late treatment 3 3 100% 33% improvement
RR 0.67 [0.39‑1.17]
p = 0.16
Prophylaxis 3 3 100% 93% improvement
RR 0.07 [0.03‑0.21]
p < 0.0001
All studies 21 24 87.5% 56% improvement
RR 0.44 [0.31‑0.63]
p < 0.0001
Table 1. Results by treatment stage.
Studies Early treatment Late treatment Prophylaxis PatientsAuthors
All studies 2451% [28‑67%]33% [-17‑61%]93% [79‑97%] 48,169 371
With exclusions 2350% [25‑67%]33% [-17‑61%]93% [79‑97%] 38,487 362
Peer-reviewed 1457% [36‑71%]19% [-17‑44%] 33,029 229
Randomized Controlled TrialsRCTs 963% [42‑76%]19% [-17‑44%]93% [79‑97%] 21,306 178
Table 2. Results by treatment stage for all studies and with different exclusions.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Regeneron (RCT) 38% 0.62 [0.29-1.33] recov. time 92 (n) 91 (n) Improvement, RR [CI] Treatment Control Regeneron (RCT) 71% 0.29 [0.17-0.48] death/hosp. 18/1,355 62/1,341 Weinreich (RCT) 50% 0.50 [0.09-2.72] death 2/2,091 4/2,089 Webb 98% 0.0 [0.00-2e+04] death 0/115 57/5,536 Cooper 77% 0.23 [0.03-1.65] death 1/1,148 33/8,534 Kakinoki 58% 0.42 [0.17-0.92] progression 13/55 22/53 Komagamine 77% 0.23 [0.01-4.63] ventilation 0/53 2/75 Suzuki (PSM) -200% 3.00 [0.12-73.3] death 1/222 0/222 O'Brien (DB RCT) 85% 0.15 [0.01-2.78] hosp. 0/100 3/104 Shopen -46% 1.46 [0.73-2.67] severe case 24/116 26/243 Osugi 24% 0.76 [0.23-2.49] hosp. 4/30 15/74 Wei 61% 0.39 [0.26-0.60] death/hosp. 23/1,116 27/5,291 Wilden 82% 0.18 [0.05-0.50] hosp. n/a n/a Faraone 92% 0.08 [0.00-1.24] death 0/11 8/23 Miyashita 33% 0.67 [0.11-3.97] ventilation 2/461 3/461 Levey 31% 0.69 [0.07-7.37] ICU 1/36 2/50 Kneidinger 97% 0.0 [0.00-1e+04] severe case 0/3 34/215 Williams -21% 1.21 [0.14-9.86] oxygen 1/88 6/676 Tau​2 = 0.24, I​2 = 47.0%, p = 0.00039 Early treatment 51% 0.49 [0.33-0.72] 90/7,092 304/25,078 51% improvement Horby (RCT) 6% 0.94 [0.86-1.02] death 943/4,839 1,029/4,946 Improvement, RR [CI] Treatment Control Somersa.. (DB RCT) 36% 0.64 [0.44-0.93] death 59/804 45/393 McCreary (PSM) 93% 0.07 [0.01-0.51] death 1/652 29/1,304 Tau​2 = 0.15, I​2 = 80.8%, p = 0.16 Late treatment 33% 0.67 [0.39-1.17] 1,003/6,295 1,103/6,643 33% improvement Regeneron (RCT) 94% 0.06 [0.00-1.10] symp. case 0/186 8/223 Improvement, RR [CI] Treatment Control Regeneron (DB RCT) 92% 0.08 [0.00-1.36] hosp. 0/841 6/842 Isa (DB RCT) 93% 0.07 [0.01-0.28] symp. case 3/729 13/240 Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Prophylaxis 93% 0.07 [0.03-0.21] 3/1,756 27/1,305 93% improvement All studies 56% 0.44 [0.31-0.63] 1,096/15,143 1,434/33,026 56% improvement 24 casirivimab/imdevimab COVID-19 studies c19early.com/r Sep 2022 Tau​2 = 0.32, I​2 = 73.1%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) Favors casirivimab/im.. Favors control
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Regeneron (RCT) 38% recovery Improvement Relative Risk [CI] Regeneron (RCT) 71% death/hosp. Weinreich (RCT) 50% death Webb 98% death Cooper 77% death Kakinoki 58% progression Komagamine 77% ventilation Suzuki (PSM) -200% death O'Brien (DB RCT) 85% hospitalization Shopen -46% severe case Osugi 24% hospitalization Wei 61% death/hosp. Wilden 82% hospitalization Faraone 92% death Miyashita 33% ventilation Levey 31% ICU admission Kneidinger 97% severe case Williams -21% oxygen therapy Tau​2 = 0.24, I​2 = 47.0%, p = 0.00039 Early treatment 51% 51% improvement Horby (RCT) 6% death Somersa.. (DB RCT) 36% death McCreary (PSM) 93% death Tau​2 = 0.15, I​2 = 80.8%, p = 0.16 Late treatment 33% 33% improvement Regeneron (RCT) 94% symp. case Regeneron (DB RCT) 92% hospitalization Isa (DB RCT) 93% symp. case Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Prophylaxis 93% 93% improvement All studies 56% 56% improvement 24 casirivimab/imdevimab COVID-19 studies c19early.com/r Sep 2022 Tau​2 = 0.32, I​2 = 73.1%, p < 0.0001 Effect extraction pre-specifiedRotate device for details Favors casirivimab/im.. Favors control
Figure 4. Random effects meta-analysis for all studies with pooled effects. This plot shows pooled effects, discussion can be found in the heterogeneity section, and results for specific outcomes can be found in the individual outcome analyses. Effect extraction is pre-specified, using the most serious outcome reported. For details of effect extraction see the appendix.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Weinreich (RCT) 50% 0.50 [0.09-2.72] 2/2,091 4/2,089 Improvement, RR [CI] Treatment Control Webb 98% 0.0 [0.00-2e+04] 0/115 57/5,536 Cooper 77% 0.23 [0.03-1.65] 1/1,148 33/8,534 Suzuki (PSM) -200% 3.00 [0.12-73.3] 1/222 0/222 Faraone 92% 0.08 [0.00-1.24] 0/11 8/23 Tau​2 = 0.00, I​2 = 0.0%, p = 0.063 Early treatment 65% 0.35 [0.12-1.06] 4/3,587 102/16,404 65% improvement Horby (RCT) 6% 0.94 [0.86-1.02] 943/4,839 1,029/4,946 Improvement, RR [CI] Treatment Control Somersa.. (DB RCT) 36% 0.64 [0.44-0.93] 59/804 45/393 McCreary (PSM) 93% 0.07 [0.01-0.51] 1/652 29/1,304 Tau​2 = 0.15, I​2 = 80.8%, p = 0.16 Late treatment 33% 0.67 [0.39-1.17] 1,003/6,295 1,103/6,643 33% improvement All studies 40% 0.60 [0.36-0.99] 1,007/9,882 1,205/23,047 40% improvement 8 casirivimab/imdevimab COVID-19 mortality results c19early.com/r Sep 2022 Tau​2 = 0.16, I​2 = 58.1%, p = 0.044 Favors casirivimab/im.. Favors control
Figure 5. Random effects meta-analysis for mortality results.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Komagamine 77% 0.23 [0.01-4.63] 0/53 2/75 Improvement, RR [CI] Treatment Control Miyashita 33% 0.67 [0.11-3.97] 2/461 3/461 Tau​2 = 0.00, I​2 = 0.0%, p = 0.39 Early treatment 50% 0.50 [0.11-2.34] 2/514 5/536 50% improvement Horby (RCT) -1% 1.01 [0.90-1.14] 484/4,556 488/4,642 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.88 Late treatment -1% 1.01 [0.90-1.14] 484/4,556 488/4,642 -1% improvement All studies -1% 1.01 [0.89-1.13] 486/5,070 493/5,178 -1% improvement 3 casirivimab/imdevimab COVID-19 mechanical ventilation results c19early.com/r Sep 2022 Tau​2 = 0.00, I​2 = 0.0%, p = 0.93 Favors casirivimab/im.. Favors control
Figure 6. Random effects meta-analysis for ventilation.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Cooper 48% 0.52 [0.23-1.20] 6/1,148 85/8,534 Improvement, RR [CI] Treatment Control Komagamine 92% 0.08 [0.00-1.32] 0/53 7/75 Levey 31% 0.69 [0.07-7.37] 1/36 2/50 Tau​2 = 0.00, I​2 = 0.0%, p = 0.05 Early treatment 53% 0.47 [0.22-1.00] 7/1,237 94/8,659 53% improvement All studies 53% 0.47 [0.22-1.00] 7/1,237 94/8,659 53% improvement 3 casirivimab/imdevimab COVID-19 ICU results c19early.com/r Sep 2022 Tau​2 = 0.00, I​2 = 0.0%, p = 0.05 Favors casirivimab/im.. Favors control
Figure 7. Random effects meta-analysis for ICU admission.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Webb 91% 0.09 [0.01-0.63] hosp. 1/115 538/5,536 Improvement, RR [CI] Treatment Control Cooper 52% 0.48 [0.35-0.64] hosp. 45/1,148 703/8,534 Komagamine 29% 0.71 [0.58-0.87] hosp. time 53 (n) 75 (n) O'Brien (DB RCT) 85% 0.15 [0.01-2.78] hosp. 0/100 3/104 Osugi 24% 0.76 [0.23-2.49] hosp. 4/30 15/74 Wei 61% 0.39 [0.30-0.51] hosp. 59/3,280 75/16,284 Wilden 82% 0.18 [0.05-0.50] hosp. n/a n/a Levey -108% 2.08 [0.81-5.33] hosp. 9/36 6/50 Williams 14% 0.86 [0.10-6.63] hosp. 1/88 8/676 Tau​2 = 0.16, I​2 = 70.0%, p = 0.0013 Early treatment 47% 0.53 [0.36-0.78] 119/4,850 1,348/31,333 47% improvement McCreary (PSM) 48% 0.52 [0.33-0.82] hosp. 22/652 85/1,304 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.0053 Late treatment 48% 0.52 [0.33-0.82] 22/652 85/1,304 48% improvement Regeneron (DB RCT) 92% 0.08 [0.00-1.36] hosp. 0/841 6/842 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.08 Prophylaxis 92% 0.08 [0.00-1.36] 0/841 6/842 92% improvement All studies 48% 0.52 [0.37-0.72] 141/6,343 1,439/33,479 48% improvement 11 casirivimab/imdevimab COVID-19 hospitalization results c19early.com/r Sep 2022 Tau​2 = 0.13, I​2 = 65.1%, p = 0.00011 Favors casirivimab/im.. Favors control
Figure 8. Random effects meta-analysis for hospitalization.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Kakinoki 58% 0.42 [0.17-0.92] 13/55 22/53 Improvement, RR [CI] Treatment Control Komagamine 68% 0.32 [0.13-0.68] 8/53 33/75 Suzuki (PSM) 45% 0.55 [0.31-0.96] 17/222 31/222 Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Early treatment 56% 0.44 [0.31-0.62] 38/330 86/350 56% improvement All studies 56% 0.44 [0.31-0.62] 38/330 86/350 56% improvement 3 casirivimab/imdevimab COVID-19 progression results c19early.com/r Sep 2022 Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Favors casirivimab/im.. Favors control
Figure 9. Random effects meta-analysis for progression.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Regeneron (RCT) 38% 0.62 [0.29-1.33] recov. time 92 (n) 91 (n) Improvement, RR [CI] Treatment Control Regeneron (RCT) 29% 0.71 [0.60-0.85] recov. time 1,355 (n) 1,341 (n) Weinreich (RCT) 29% 0.71 [0.58-0.87] recov. time 1,355 (n) 1,341 (n) Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Early treatment 29% 0.71 [0.63-0.81] 0/2,802 0/2,773 29% improvement Somersa.. (DB RCT) 30% 0.70 [0.52-0.94] no disch. 90/804 63/393 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.018 Late treatment 30% 0.70 [0.52-0.94] 90/804 63/393 30% improvement Regeneron (DB RCT) 62% 0.38 [0.23-0.61] recov. time 753 (n) 752 (n) Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.0001 Prophylaxis 62% 0.38 [0.23-0.61] 0/753 0/752 62% improvement All studies 33% 0.67 [0.57-0.78] 90/4,359 63/3,918 33% improvement 5 casirivimab/imdevimab COVID-19 recovery results c19early.com/r Sep 2022 Tau​2 = 0.01, I​2 = 36.4%, p < 0.0001 Favors casirivimab/im.. Favors control
Figure 10. Random effects meta-analysis for recovery.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ O'Brien (DB RCT) 33% 0.67 [0.43-0.98] symp. case 29/100 44/104 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.039 Early treatment 33% 0.67 [0.43-0.98] 29/100 44/104 33% improvement Regeneron (RCT) 94% 0.06 [0.00-1.10] symp. case 0/186 8/223 Improvement, RR [CI] Treatment Control Regeneron (DB RCT) 81% 0.19 [0.12-0.30] cases 20/841 108/842 Isa (DB RCT) 93% 0.07 [0.01-0.28] symp. case 3/729 13/240 Tau​2 = 0.05, I​2 = 11.7%, p < 0.0001 Prophylaxis 85% 0.15 [0.09-0.26] 23/1,756 129/1,305 85% improvement All studies 80% 0.20 [0.07-0.61] 52/1,856 173/1,409 80% improvement 4 casirivimab/imdevimab COVID-19 case results c19early.com/r Sep 2022 Tau​2 = 0.89, I​2 = 88.3%, p = 0.0043 Favors casirivimab/im.. Favors control
Figure 11. Random effects meta-analysis for cases.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ O'Brien (DB RCT) 40% 0.60 [0.45-0.81] viral load 100 (n) 104 (n) Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.001 Early treatment 40% 0.60 [0.45-0.81] 0/100 0/104 40% improvement Regeneron (DB RCT) 69% 0.31 [0.17-0.55] viral time 753 (n) 752 (n) Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Prophylaxis 69% 0.31 [0.17-0.55] 0/753 0/752 69% improvement All studies 55% 0.45 [0.24-0.87] 0/853 0/856 55% improvement 2 casirivimab/imdevimab COVID-19 viral clearance results c19early.com/r Sep 2022 Tau​2 = 0.17, I​2 = 74.9%, p = 0.017 Favors casirivimab/im.. Favors control
Figure 12. Random effects meta-analysis for viral clearance.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Weinreich (RCT) 50% 0.50 [0.09-2.72] death 2/2,091 4/2,089 Improvement, RR [CI] Treatment Control Webb 98% 0.0 [0.00-2e+04] death 0/115 57/5,536 Cooper 77% 0.23 [0.03-1.65] death 1/1,148 33/8,534 Kakinoki 58% 0.42 [0.17-0.92] progression 13/55 22/53 Komagamine