The effect of combination treatment with casirivimab and imdevimab versus standard antiviral therapy on clinical outcomes in hospitalized COVID-19 patients

Abstract Background The Coronavirus Disease of 2019 (COVID-19) pandemic motivated research efforts to address this catastrophe from the beginning of 2020 to the present. The year 2021 is coming to an end, and several developments in pharmacotherapy for COVID-19 have occurred. In terms of antiviral therapy, monoclonal antibody combinations have become one type of COVID-19 immunotherapy. Remdesivir and favipiravir are two antiviral medications typically used to treat COVID-19. Paxlovid (nirmatrelvir plus ritonavir) and molnupiravir are other antiviral agents used in COVID-19. The purpose of this study was to compare the effects of combinations of antibodies (casirivimab and imdevimab), remdesivir, and favipiravir on COVID-19 swab results in hospitalized patients with COVID-19 at discharge. Methods This research is a phase IV non-randomized controlled trial ( Results Compared to remdesivir and favipiravir, casirivimab and imdevimab cause less hepatotoxicity, less renal impairment, and more negative swab results at discharge. The three tested antivirals also had no significant adverse effects. All three antivirals are considered safe based on these findings. Conclusion Compared with remdesivir and favipiravir, casirivimab and imdevimab result in better clinical outcomes. All three antivirals are safe and have no significant toxicity. Trial registration: Clinicaltrials.gov, NCT05502081, 16/08/2022.