Clinical Effectiveness of Regdanvimab Treatment for Mild to Moderate COVID-19: A Retrospective Cohort Study

Effectiveness of regdanvimab on mortality in COVID-19 infected patients on hemodialysis

BACKGROUND

Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (COVID-19), there are lack of effective and proven treatments for end-stage renal disease (ESRD). The present study aims to evaluate the effectiveness of regdanvimab on mortality in COVID-19-infected patients on hemodialysis (HD).

METHODS

We conducted an observational retrospective study in 230 COVID-19-infected patients on HD, of whom 77 (33.5%) were administered regdanvimab alone or in combination with dexamethasone or remdesivir during hospitalization (regdanvimab group) and 153 patients (66.5%) were not (no regdanvimab group). The primary outcome was in-hospital mortality. We compared mortality rates according to the use of regdanvimab and investigated the factors associated with mortality.

RESULTS

Fifty-nine deaths occurred during hospitalization, 49 in the no regdanvimab group (32.0%) and 10 in the regdanvimab group (13.0%), and the mortality rate was significantly higher in the no regdanvimab group than that in the regdanvimab group (p = 0.001). Multivariate Cox regression analysis showed that malignancy (p = 0.001), SPO2 of <95% at admission (p = 0.003), and administration of antibiotics and regdanvimab (p = 0.007 and p = 0.002, respectively) were significantly associated factors with mortality.

CONCLUSION

Regdanvimab administration is beneficial in improving prognosis in hospitalized COVID-19 patients on HD. Considering the vulnerability to infection and high mortality of ESRD patients, regdanvimab may be considered as a therapeutic option in COVID-19 patients on HD.

Safety and Effectiveness of Regdanvimab for COVID-19 Treatment: A Phase 4 Post-marketing Surveillance Study Conducted in South Korea

INTRODUCTION

Regdanvimab, a neutralising monoclonal antibody (mAb) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), received approval for the treatment of coronavirus disease 2019 (COVID-19) in South Korea in 2021. The Ministry of Food and Drug Safety in South Korea mandate that new medications be re-examined for safety and effectiveness post-approval in at least 3000 individuals. This post-marketing surveillance (PMS) study was used to evaluate the safety and effectiveness of regdanvimab in real-world clinical care.

METHODS

This prospective, multicentre, phase 4 PMS study was conducted between February 2021 and March 2022 in South Korea. Eligible patients were aged ≥ 18 years with confirmed mild COVID-19 at high risk of disease progression or moderate COVID-19. Patients were hospitalised and treated with regdanvimab (40 mg/kg, day 1) and then monitored until discharge, with a follow-up call on day 28. Adverse events (AEs) were documented, and the COVID-19 disease progression rate was used to measure effectiveness.

RESULTS

Of the 3123 patients with COVID-19 infection identified, 3036 were eligible for inclusion. Approximately 80% and 5% of the eligible patients were diagnosed with COVID-19 during the delta- and omicron-dominant periods, respectively. Median (range) age was 57 (18-95) years, and 50.6% of patients were male. COVID-19 severity was assessed before treatment, and high-risk mild and moderate COVID-19 was diagnosed in 1030 (33.9%) and 2006 (66.1%) patients, respectively. AEs and adverse drug reactions (ADRs) were experienced by 684 (22.5%) and 363 (12.0%) patients, respectively. The most common ADR was increased liver function test (n = 62, 2.0%). Nine (0.3%) patients discontinued regdanvimab due to ADRs. Overall, 378 (12.5%) patients experienced disease progression after regdanvimab infusion, with extended hospitalisation/re-admission (n = 300, 9.9%) as the most common reason. Supplemental oxygen was required by 282 (9.3%) patients. Ten (0.3%) patients required intensive care monitoring and 3 (0.1%) died due to COVID-19.

CONCLUSION

This large-scale PMS study demonstrated that regdanvimab was effective against COVID-19 progression and had an acceptable safety profile when used in real-world clinical practice.

Efficacy and safety of regdanvimab in patients with mild to moderate COVID-19: A rapid review and meta-analysis

AIMS

This study aimed to evaluate the efficacy and safety of regdanvimab, an anti-SARS-COV-2 monoclonal antibody approved by the European Medicines Agency in November 2021, for the treatment of confirmed COVID-19 disease.

METHODS

Cochrane Library, PubMed, medRxiv and Google Scholar were searched for relevant evidence up to October 27, 2022. The quality of included studies was assessed using the Cochrane risk of bias tools. Data were analysed using RevMan software.

RESULTS

Eight studies involving 4793 patients were included. A significant difference was observed between the regdanvimab and no-regdanvimab groups in terms of length of hospital stay (mean difference [MD] = -1.15, 95% confidence interval [CI]: -1.80 to -0.43), clinical recovery (odds ratio [OR] = 2.09, 95% CI: 1.38 to 3.18), disease progression (OR = 0.23, 95% CI: 0.16 to 0.33), the need for oxygen therapy (OR = 0.33, 95% CI: 0.25 to 0.43) and duration of oxygen therapy (MD = -3.00, 95% CI: -4.44 to -1.56). However, no significant difference was detected between 2 groups regarding mortality rate (OR = 0.46, 95% CI: 0.11 to 1.89), need for mechanical ventilation (OR = 0.39, 95% CI: 0.08 to 1.89) and hospital admission rate (OR = 0.61, 95% CI: 0.35 to 1.03). The incidence of adverse events was similar in both groups (OR = 0.96, 95% CI: 0.77 to 1.18).

CONCLUSION

Regdanvimab was not effective in reducing mortality and hospital admission rate in patients with mild to moderate COVID-19, but it was effective in improving other efficacy outcomes. Further research is needed to confirm these findings.