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WHO Issues Guidance for Use of Casirivimab-Imdevimab in COVID-19

Combo conditionally recommended for patients with nonsevere disease at risk for severe disease, seronegative patients with severe infection

FRIDAY, Sept. 24, 2021 (HealthDay News) — Use of two recombinant human monoclonal antibodies that bind to the severe acute respiratory syndrome coronavirus 2 spike protein, casirivimab and imdevimab, is conditionally recommended for patients with nonsevere disease at highest risk for severe disease and for severe and critical infection among seronegative patients, according to a living guideline published online Sept. 24 in The BMJ.

Bram Rochwerg, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues developed a guideline update based on preprints of four randomized trials among patients with nonsevere illness and a trial among severe and critically ill patients with COVID-19.

The researchers conditionally recommend that the combination of casirivimab and imdevimab should be used for patients with nonsevere disease at highest risk for severe disease. The evidence demonstrated a likely reduction in the need for hospitalization, with greater absolute benefit for those at highest risk for hospitalization. Pooled data indicated trivial or no effects on mortality or need for mechanical ventilation due to very low risk at baseline. For patients with severe and critical infection, casirivmab-imdevimab is conditionally recommended if the individual has seronegative status. In these patients, casirivimab-imdevimab probably reduces mortality and may reduce the need for mechanical ventilation. At the time of presentation of severe or critical illness, rapid identification of serologic status is needed.

“This is a living guideline, so the recommendations included here will be updated and new recommendations will be added for other drugs for COVID-19,” the authors write.

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