11/3 Early treatment study
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab546 (Peer Reviewed)
Bamlanivimab efficacy in older and high BMI outpatients with Covid-19 selected for treatment in a lottery-based allocation process
Bamlanivimab efficacy in older and high BMI outpatients with Covid-19 selected for treatment in a lottery-based allocation process
Retrospective database analysis of 1257 PCR+ outpatients with age ≥65, BMI≥35, 191 receiving bamlanivimab via lottery. Authors note that the alpha variant was most common during the study period, and that efficacy against other variants can be much lower. Authors note confounding due to prioritization in the lottery and differential reporting in the database. The adjusted mortality result is in the abstract, with no details or mention in the paper, and we note that the change after adjustments is large: RR 0.56 -> OR 0.03.
risk of death, 97.0% lower, RR 0.03, p < 0.01, treatment 1 of 191 (0.5%), control 10 of 1,066 (0.9%), odds ratio converted to relative risk.
risk of hospitalization, 65.3% lower, RR 0.35, p = 0.04, treatment 16 of 191 (8.4%), control 121 of 1,065 (11.4%), odds ratio converted to relative risk, IPTW weighted logistic regression.
This study is excluded in the after exclusion results of meta
analysis:
significant unadjusted confounding possible.
Conflicts of interest:
research funding from the drug patent holder, consulting for the pharmaceutical industry.
Rubin et al., 11/3/2021, retrospective, USA, North America, peer-reviewed, 7 authors.
Effect extraction follows pre-specified rules
prioritizing more serious outcomes. For an individual study the most serious
outcome may have a smaller number of events and lower statistical signficance,
however this provides the strongest evidence for the most serious outcomes
when combining the results of many trials.
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