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Hager KJ, Pérez Marc G, Gobeil P, Diaz RS, Heizer G, Llapur C, Makarkov AI, Vasconcellos E, Pillet S, Riera F, Saxena P, Geller Wolff P, Bhutada K, Wallace G, Aazami H, Jones CE, Polack FP, Ferrara L, Atkins J, Boulay I, Dhaliwall J, Charland N, Couture MMJ, Jiang-Wright J, Landry N, Lapointe S, Lorin A, Mahmood A, Moulton LH, Pahmer E, Parent J, Séguin A, Tran L, Breuer T, Ceregido MA, Koutsoukos M, Roman F, Namba J, D'Aoust MA, Trepanier S, Kimura Y, Ward BJ. Efficacy and Safety of a Recombinant Plant-Based Adjuvanted Covid-19 Vaccine. N Engl J Med 2022; 386:2084-2096. [PMID: 35507508 PMCID: PMC9127773 DOI: 10.1056/nejmoa2201300] [Citation(s) in RCA: 98] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Coronavirus-like particles (CoVLP) that are produced in plants and display the prefusion spike glycoprotein of the original strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are combined with an adjuvant (Adjuvant System 03 [AS03]) to form the candidate vaccine. METHODS In this phase 3, multinational, randomized, placebo-controlled trial conducted at 85 centers, we assigned adults (≥18 years of age) in a 1:1 ratio to receive two intramuscular injections of the CoVLP+AS03 vaccine or placebo 21 days apart. The primary objective of the trial was to determine the efficacy of the CoVLP+AS03 vaccine in preventing symptomatic coronavirus disease 2019 (Covid-19) beginning at least 7 days after the second injection, with the analysis performed after the detection of at least 160 cases. RESULTS A total of 24,141 volunteers participated in the trial; the median age of the participants was 29 years. Covid-19 was confirmed by polymerase-chain-reaction assay in 165 participants in the intention-to-treat population; all viral samples that could be sequenced contained variants of the original strain. Vaccine efficacy was 69.5% (95% confidence interval [CI], 56.7 to 78.8) against any symptomatic Covid-19 caused by five variants that were identified by sequencing. In a post hoc analysis, vaccine efficacy was 78.8% (95% CI, 55.8 to 90.8) against moderate-to-severe disease and 74.0% (95% CI, 62.1 to 82.5) among the participants who were seronegative at baseline. No severe cases of Covid-19 occurred in the vaccine group, in which the median viral load for breakthrough cases was lower than that in the placebo group by a factor of more than 100. Solicited adverse events were mostly mild or moderate and transient and were more frequent in the vaccine group than in the placebo group; local adverse events occurred in 92.3% and 45.5% of participants, respectively, and systemic adverse events in 87.3% and 65.0%. The incidence of unsolicited adverse events was similar in the two groups up to 21 days after each dose (22.7% and 20.4%) and from day 43 through day 201 (4.2% and 4.0%). CONCLUSIONS The CoVLP+AS03 vaccine was effective in preventing Covid-19 caused by a spectrum of variants, with efficacy ranging from 69.5% against symptomatic infection to 78.8% against moderate-to-severe disease. (Funded by Medicago; ClinicalTrials.gov number, NCT04636697.).
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Affiliation(s)
- Karen J Hager
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Gonzalo Pérez Marc
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Philipe Gobeil
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Ricardo S Diaz
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Gretchen Heizer
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Conrado Llapur
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Alexander I Makarkov
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Eduardo Vasconcellos
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Stéphane Pillet
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Fernando Riera
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Pooja Saxena
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Priscila Geller Wolff
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Kapil Bhutada
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Garry Wallace
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Hessam Aazami
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Christine E Jones
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Fernando P Polack
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Luciana Ferrara
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Judith Atkins
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Iohann Boulay
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Jiwanjeet Dhaliwall
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Nathalie Charland
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Manon M J Couture
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Julia Jiang-Wright
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Nathalie Landry
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Sophie Lapointe
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Aurélien Lorin
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Asif Mahmood
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Lawrence H Moulton
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Emmy Pahmer
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Julie Parent
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Annie Séguin
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Luan Tran
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Thomas Breuer
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Maria-Angeles Ceregido
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Marguerite Koutsoukos
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - François Roman
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Junya Namba
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Marc-André D'Aoust
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Sonia Trepanier
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Yosuke Kimura
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
| | - Brian J Ward
- From Medicago, Quebec, QC (K.J.H., P.G., G.H., A.I.M., S.P., P.S., K.B., J.A., I.B., J.D., N.C., M.M.J.C., J.J.-W., N.L., S.L., A.L., A.M., E.P., J.P., A.S., L.T., J.N., M.-A.D., S.T., Y.K., B.J.W.), Dawson Clinical Research, Guelph, ON (G.W.), and Research Institute of the McGill University Health Center, Montreal (B.J.W.) - all in Canada; Hospital Militar (G.P.M.) and Fundación INFANT (F.P.P.), Buenos Aires, Clinica Mayo de Urgencias Medicas Cruz Blanca, Tucuman (C.L.), and Sanatorio Allende, Cordoba (F. Riera) - all in Argentina; the Infectious Diseases Division, Paulista School of Medicine, Federal University of São Paulo, and Azidus Brasil Pesquisa e Desenvolvimento, São Paulo (R.S.D., L.F.), Instituto de Pesquisas Clinicas L2IP, Brasilia (E.V.), and Instituto Brasil de Pequisa Clinica, Rio de Janeiro (P.G.W.) - all in Brazil; Hope Clinical, Canoga Park, CA (H.A.); Clinical and Experimental Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (C.E.J.); the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (L.H.M.); and GlaxoSmithKline Vaccines, Wavre, Belgium (T.B., M.-A.C., M.K., F. Roman)
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Weinreich DM, Sivapalasingam S, Norton T, Ali S, Gao H, Bhore R, Xiao J, Hooper AT, Hamilton JD, Musser BJ, Rofail D, Hussein M, Im J, Atmodjo DY, Perry C, Pan C, Mahmood A, Hosain R, Davis JD, Turner KC, Baum A, Kyratsous CA, Kim Y, Cook A, Kampman W, Roque-Guerrero L, Acloque G, Aazami H, Cannon K, Simón-Campos JA, Bocchini JA, Kowal B, DiCioccio AT, Soo Y, Geba GP, Stahl N, Lipsich L, Braunstein N, Herman G, Yancopoulos GD. REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19. N Engl J Med 2021; 385:e81. [PMID: 34587383 PMCID: PMC8522800 DOI: 10.1056/nejmoa2108163] [Citation(s) in RCA: 390] [Impact Index Per Article: 130.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the phase 1-2 portion of an adaptive trial, REGEN-COV, a combination of the monoclonal antibodies casirivimab and imdevimab, reduced the viral load and number of medical visits in patients with coronavirus disease 2019 (Covid-19). REGEN-COV has activity in vitro against current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern. METHODS In the phase 3 portion of an adaptive trial, we randomly assigned outpatients with Covid-19 and risk factors for severe disease to receive various doses of intravenous REGEN-COV or placebo. Patients were followed through day 29. A prespecified hierarchical analysis was used to assess the end points of hospitalization or death and the time to resolution of symptoms. Safety was also evaluated. RESULTS Covid-19-related hospitalization or death from any cause occurred in 18 of 1355 patients in the REGEN-COV 2400-mg group (1.3%) and in 62 of 1341 patients in the placebo group who underwent randomization concurrently (4.6%) (relative risk reduction [1 minus the relative risk], 71.3%; P<0.001); these outcomes occurred in 7 of 736 patients in the REGEN-COV 1200-mg group (1.0%) and in 24 of 748 patients in the placebo group who underwent randomization concurrently (3.2%) (relative risk reduction, 70.4%; P = 0.002). The median time to resolution of symptoms was 4 days shorter with each REGEN-COV dose than with placebo (10 days vs. 14 days; P<0.001 for both comparisons). REGEN-COV was efficacious across various subgroups, including patients who were SARS-CoV-2 serum antibody-positive at baseline. Both REGEN-COV doses reduced viral load faster than placebo; the least-squares mean difference in viral load from baseline through day 7 was -0.71 log10 copies per milliliter (95% confidence interval [CI], -0.90 to -0.53) in the 1200-mg group and -0.86 log10 copies per milliliter (95% CI, -1.00 to -0.72) in the 2400-mg group. Serious adverse events occurred more frequently in the placebo group (4.0%) than in the 1200-mg group (1.1%) and the 2400-mg group (1.3%); infusion-related reactions of grade 2 or higher occurred in less than 0.3% of the patients in all groups. CONCLUSIONS REGEN-COV reduced the risk of Covid-19-related hospitalization or death from any cause, and it resolved symptoms and reduced the SARS-CoV-2 viral load more rapidly than placebo. (Funded by Regeneron Pharmaceuticals and others; ClinicalTrials.gov number, NCT04425629.).
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MESH Headings
- Adolescent
- Adult
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/pharmacokinetics
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Neutralizing/administration & dosage
- Antibodies, Neutralizing/pharmacology
- Antiviral Agents/administration & dosage
- Antiviral Agents/pharmacokinetics
- Antiviral Agents/pharmacology
- COVID-19/mortality
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Combinations
- Female
- Hospitalization/statistics & numerical data
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Pregnancy
- Pregnancy Complications, Infectious/drug therapy
- Proportional Hazards Models
- Viral Load/drug effects
- Young Adult
- COVID-19 Drug Treatment
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Affiliation(s)
- David M Weinreich
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Sumathi Sivapalasingam
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Thomas Norton
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Shazia Ali
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Haitao Gao
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Rafia Bhore
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Jing Xiao
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Andrea T Hooper
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Jennifer D Hamilton
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Bret J Musser
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Diana Rofail
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Mohamed Hussein
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Joseph Im
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Dominique Y Atmodjo
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Christina Perry
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Cynthia Pan
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Adnan Mahmood
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Romana Hosain
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - John D Davis
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Kenneth C Turner
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Alina Baum
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Christos A Kyratsous
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Yunji Kim
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Amanda Cook
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Wendy Kampman
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Lilia Roque-Guerrero
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Gerard Acloque
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Hessam Aazami
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Kevin Cannon
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - J Abraham Simón-Campos
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Joseph A Bocchini
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Bari Kowal
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - A Thomas DiCioccio
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Yuhwen Soo
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Gregory P Geba
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Neil Stahl
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Leah Lipsich
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Ned Braunstein
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - Gary Herman
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
| | - George D Yancopoulos
- From Regeneron Pharmaceuticals, Tarrytown (D.M.W., T.N., S.A., H.G., R.B., J.X., A.T.H., J.D.H., B.J.M., D.R., M.H., J.I., D.Y.A., C. Perry, C. Pan, A.M., R.H., J.D.D., K.C.T., A.B., C.A.K., Y.K., A.C., W.K., B.K., A.T.D., Y. S., G.P.G., N.S., L.L., N.B., G.H., G.D.Y.) and Excision BioTherapeutics, New York (S.S.) - both in New York; Bio-Medical Research (L.R.-G.) and Universal Medical and Research Center (G.A.) - both in Miami; Hope Clinical Research, Canoga Park, CA (H.A.); PMG Research of Wilmington, Wilmington, NC (K.C.); Köhler and Milstein Research, Hospital General Agustín O'Horan, Mérida, Mexico (J.A.S.-C.); and the Willis-Knighton Physician Network, Shreveport, LA (J.A.B)
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