The efficacy and safety of bamlanivimab treatment against COVID-19: A meta-analysis

  1. Huai-rong Xiang
  2. Bei He
  3. Yun Li
  4. Xuan Cheng
  5. Qi-zhi Zhang
  6. Wen-xing Peng

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Abstract

Background

Bamlanivimab is routinely used in the treatment of coronavirus disease 2019 (COVID-19) in worldwide. We performed a meta-analysis to investigate the efficacy and safety of bamlanivimab treatment in patients with COVID-19.

Methods

We searched articles from Web of Science, PubMed, Embase, the Cochrane Library and MedRxiv between 30 January 2020 and August 5, 2021. We selected randomized clinical trials (RCTs) and observational studies with a control group to assess the efficiency of bamlanivimab in treating patients with COVID-19.

Results

Our meta-analysis retrieved 3 RCTs and 7 cohort studies including 14461 patients. Bmlanivimab may help outpatients to prevent hospitalization or emergency department visit (RR 0.41 95%CI 0.29 to 0.58), reduce ICU admission (RR 0.47 95%CI 0.23 to 0.92) and mortality (RR 0.32 95%CI 0.13 to 0.77) from the disease. The combination of bamlanivimab and etesevimab may had a greater potential for positive treatment outcome.

Conclusion

Bamlanivimab has demonstrated clinical efficacy on mild or moderate ill patients with COVID-19 to prevent hospitalization, reduce severity and mortality from the disease. Combinations of two or more monoclonal antibody increase the effect. Well-designed clinical trials to identify the clinical and biochemical characteristics in COVID-19 patients’ population that could benefit from bamlanivimab are warranted in the future.

Key points

Question

Can bamlanivimab treat COVID-19 patients? What are the factors that have great impact on the treatment outcome?

Findings

In this meta-analysis that retrieved 3 RCTs and 7 cohort studies and included 14461 adults, Bmlanivimab may help outpatients to prevent hospitalization or emergency department visit (RR 0.41 95%CI 0.29 to 0.58), reduce ICU admission (RR 0.47 95%CI 0.23 to 0.92) and mortality (RR 0.32 95%CI 0.13 to 0.77) from the disease.

Meaning

In COVID-19 pandemic, the use of bamlanivimab may be warranted. Combinations of two or more monoclonal antibody increase the effect.

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  1. ScreenIT

    SciScore for 10.1101/2021.08.24.21262580: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    BlindingThe version 2 Cochrane Risk of bias Assessment tool[9] was used to evaluate the methodological quality of the RCTs over five domains of selection, performance, blinding, completeness, and reporting.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Search strategy and study selection: Two experience researchers (Bei He and Xuan Cheng) based on The Peer Review of Electronic Search Strategies checklist[8] searched Web of Science, PubMed, Embase, the Cochrane Library, MedRxiv for clinical trials and observational studies.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    Cochrane Library
    suggested: (Cochrane Library, RRID:SCR_013000)
    Each included article was thoroughly reviewed, the following data and information were extracted: Data was extracted and entered to a pre-defined and piloted Microsoft excel database.
    Microsoft excel
    suggested: (Microsoft Excel, RRID:SCR_016137)
    Statistical Analysis: All statistical analysis was conducted by Stata 16 (StataCorp, College Station, SE) software.
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are some limitations on our meta-analysis. First, groups in some studies were unlikely considered to be comparable on each variable used in the adjustment such as immunosuppression and comorbidity. Second, the small number of participants in some RCTs may increase the likelihood of type II statistical error. Larger scale RCTs are required to confirm the findings. Third, the primary focus of this meta-analyses was cohort studies. Theoretically, observational studies would overestimate the treatment effect of the interventions [27]. Fourth, the data were too limited to perform more meaningful outcome or subgroup analyses. Fifth, the results of egger’s test mean there were high risk of selective reporting or of publication bias.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04427501RecruitingA Study of LY3819253 (LY-CoV555) and LY3832479 (LY-CoV016) i…

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.08.24.21262580v1 on medRxiv