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Effectiveness of regdanvimab treatment for SARS-CoV-2 delta variant, which exhibited decreased in vitro activity: a nationwide real-world multicenter cohort study

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Author(s)
Haein KimYoung Rock JangJi Yeon LeeJae-Hoon KoJee Young LeeSeongcheol ChoYong Dae LeeJunghoon SongMiri HyunHyun Ah KimSoyoon HwangSangmi RyouYoo Jin NaJoo-Yeon LeeChanghee LeeNan Young LeeSeunghwan ShinKi Tae KwonJin Yong KimKyong Ran Peck
Keimyung Author(s)
Lee, Ji YeonHyun, Mi RiKim, Hyun Ah
Department
Dept. of Internal Medicine (내과학)
Journal Title
Front Cell Infect Microbiol
Issued Date
2023
Volume
13
Keyword
SARS-CoV-2delta variantmonoclonal antibodyoutcomeregdanvimab
Abstract
Background:
Immune-evading severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants are emerging continuously. The clinical effectiveness of monoclonal antibody agents that exhibit decreased in vitro activity against SARS-CoV-2 variants needs to be elucidated.

Methods:
A nationwide, multicenter, retrospective cohort study was designed to evaluate the effectiveness of regdanvimab, an anti-SARS-CoV-2 monoclonal antibody agent. Regdanvimab was prescribed in South Korea before and after the emergence of the delta variant, against which the in vitro activity of regdanvimab was decreased but present. Mild to moderate coronavirus 2019 (COVID-19) patients with risk factors for disease progression who were admitted within seven days of symptom onset were screened in four designated hospitals between December 2020 and September 2021. The primary outcomes, O2 requirements and progression to severe disease within 21 days of admission, were compared between the regdanvimab and supportive care groups, with a subgroup analysis of delta variant-confirmed patients.

Results:
A total of 2,214 mild to moderate COVID-19 patients were included, of whom 1,095 (49.5%) received regdanvimab treatment. In the analysis of the total cohort, significantly fewer patients in the regdanvimab group than the supportive care group required O2 support (18.4% vs. 27.1%, P < 0.001) and progressed to severe disease (4.0% vs. 8.0%, P < 0.001). In the multivariable analysis, regdanvimab was significantly associated with a decreased risk for O2 support (HR 0.677, 95% CI 0.561-0.816) and progression to severe disease (HR 0.489, 95% CI 0.337-0.709). Among the 939 delta-confirmed patients, O2 support (21.5% vs. 23.5%, P = 0.526) and progression to severe disease (4.2% vs. 7.3%, P = 0.055) did not differ significantly between the regdanvimab and supportive care groups. In the multivariable analyses, regdanvimab treatment was not significantly associated with a decreased risk for O2 support (HR 0.963, 95% CI 0.697-1.329) or progression to severe disease (HR 0.665, 95% CI 0.349-1.268) in delta-confirmed group.

Conclusions:
Regdanvimab treatment effectively reduced progression to severe disease in the overall study population, but did not show significant effectiveness in the delta-confirmed patients. The effectiveness of dose increment of monoclonal antibody agents should be evaluated for variant strains exhibiting reduced susceptibility.
Keimyung Author(s)(Kor)
이지연
현미리
김현아
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2235-2988
Source
https://www.frontiersin.org/articles/10.3389/fcimb.2023.1192512/full
DOI
10.3389/fcimb.2023.1192512
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44975
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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