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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Death/ICU 74% Improvement Relative Risk Sotrovimab  Behzad et al.  EARLY TREATMENT Is early treatment with sotrovimab beneficial for COVID-19? Retrospective 1,180 patients in Bahrain (January - March 2022) Lower death/ICU with sotrovimab (p=0.0015) c19early.org Behzad et al., J. Infection and Public.., Dec 2023 Favors sotrovimab Favors control

Real world Effectiveness of Sotrovimab in Preventing COVID-19–related Hospitalisation or Death in Patients Infected with Omicron BA.2

Behzad et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2023.11.029
Dec 2023  
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Sotrovimab for COVID-19
39th treatment shown to reduce risk in May 2023
 
*, now known with p = 0.0017 from 22 studies, recognized in 37 countries. Efficacy is variant dependent.
Lower risk for hospitalization.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments. c19early.org
Analysis of 1,180 high-risk COVID-19 outpatients infected with Omicron BA.2 showing lower risk of death or ICU admission with sotrovimab treatment.
Confounding by treatment propensity. This study analyzes a population where only a fraction of eligible patients received the treatment. Patients receiving treatment may be more likely to follow other recommendations, more likely to receive additional care, and more likely to use additional treatments that are not tracked in the data (e.g., nasal/oral hygiene c19early.org, c19early.org (B), vitamin D c19early.org (C), etc.) — either because the physician recommending sotrovimab also recommended them, or because the patient seeking out sotrovimab is more likely to be familiar with the efficacy of additional treatments and more likely to take the time to use them. Therefore, these kind of studies may overestimate the efficacy of treatments.
Efficacy is variant dependent. In Vitro studies predict lower efficacy for BA.1 Liu, Sheward, VanBlargan, BA.4, BA.5 Haars, XBB.1.9.3, XBB.1.5.24, XBB.2.9, CH.1.1 Pochtovyi, and no efficacy for BA.2 Zhou, ХВВ.1.9.1, XBB.1.16, BQ.1.1.45, and CL.1 Pochtovyi. US EUA has been revoked.
risk of death/ICU, 74.4% lower, HR 0.26, p = 0.001, treatment 569, control 611.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Behzad et al., 4 Dec 2023, retrospective, Bahrain, peer-reviewed, 6 authors, study period 1 January, 2022 - 31 March, 2022. Contact: mqahtani@rcsi-mub.com, dr.abehzad@gmail.com, dr.aamalmohamed@gmail.com, 19202638@rcsi-mub.com, 20202566@rcsi.com, abutler@rcsi.com.
This PaperSotrovimabAll
Real world Effectiveness of Sotrovimab in Preventing COVID-19–related Hospitalisation or Death in Patients Infected with Omicron BA.2
Alwaleed Behzad, Aamal Mohamed, Ahmed Ali, Sara Niinuma, Alexandra E Butler, Manaf Alqahtani
Journal of Infection and Public Health, doi:10.1016/j.jiph.2023.11.029
Background. Laboratory-based evidence indicates that neutralization of the BA.2 (Omicron) variant by sotrovimab is reduced versus previous SARS-CoV-2 variants. Since there is a lack of real-world data, we investigated whether sotrovimab has reduced clinical efficacy against the BA.2 variant. Methods. We performed a prospective cohort study using real-world data from 1180 randomlyselected BA.2 variant-infected patients. Follow-up to study endpoints averaged 29 days. For mild cases (not requiring oxygen-supplementation), primary outcomes were requiring O2supplementation, intensive care unit (ICU) admission or death. For moderate-to-severe COVID-19 cases (requiring oxygen-supplementation other than mechanical ventilation), the primary outcome was ICU admission or death. Results. Patients in the sotrovimab group (n=569) and control patients (n=611) were included. Sotrovimab-treated patients versus controls had reduced risk of death (0.4% vs 6.4%, p<0.001), need for oxygen supplementation (3.5% vs 12.8%, p<0.001) and ICU admission (0.2% vs 4.9%, p<0.001). The adjusted-odds ratio for developing any of these outcomes was 0.090 (95% CI 0.049-0.165, p<0.001). Subgroup analysis of moderate-to-severe sotrovimab-treated patients versus controls revealed reduced mortality (17.7% vs 37.2%, p=0.006) and ICU admission (0.0% vs 37.2%, p<0.001). Adjusted-hazards ratio for death or ICU admission was 0.256 (95% CI 0.111-0.593, p<0.001). Conclusion. Sotrovimab was effective in reducing COVID-19 progression risk in high-risk BA.2 variant-infected patients. This finding may alleviate concerns about its clinical efficacy.
Ethics approval and consent to participate: The study was approved by the National COVID-19 Research Committee and the Bahrain Defence Force Hospital Ethics committee (Study code: CRT-COVID2022-155, approved on January 24, 2022). The study was conducted according to the Declaration of Helsinki, the International Conference on Harmonization Good Clinical Practices guidelines (ICH-GCP E6) and local regulations. All patients enrolled in the study provided written informed consent. Consent for publication: All authors gave their consent for publication. Conflict of interest: None of the authors have any conflict of interest to declare. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. a Mortality is significantly higher in the moderate-to-severe cases as compared to controls. b Oxygen supplementation was significantly lower in the moderate-to-severe cases as compared to control. c ICU admission was significantly lower in the moderate-to-severe cases as compared to control. d Main outcome of any of the three above was not significantly different between the moderate-to-severe cases and the control. *Significant difference at the level of p<0.05. J o u r n a l P r e -p r o o f
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