Skip to main content
Top
Published in: Infectious Diseases and Therapy 10/2023

Open Access 13-10-2023 | COVID-19 | Original Research

Safety and Effectiveness of Regdanvimab for COVID-19 Treatment: A Phase 4 Post-marketing Surveillance Study Conducted in South Korea

Authors: Ji Yeon Lee, Seon Hee Bu, EunHyang Song, Seongcheol Cho, Sungbong Yu, Jungok Kim, Sungmin Kym, Kwang Won Seo, Ki Tae Kwon, Jin Yong Kim, Sunghyun Kim, Keumyoung Ahn, Nahyun Jung, Yeonmi Lee, Yoobin Jung, Chankyoung Hwang, Sang Won Park

Published in: Infectious Diseases and Therapy | Issue 10/2023

Login to get access

Abstract

Introduction

Regdanvimab, a neutralising monoclonal antibody (mAb) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), received approval for the treatment of coronavirus disease 2019 (COVID-19) in South Korea in 2021. The Ministry of Food and Drug Safety in South Korea mandate that new medications be re-examined for safety and effectiveness post-approval in at least 3000 individuals. This post-marketing surveillance (PMS) study was used to evaluate the safety and effectiveness of regdanvimab in real-world clinical care.

Methods

This prospective, multicentre, phase 4 PMS study was conducted between February 2021 and March 2022 in South Korea. Eligible patients were aged ≥ 18 years with confirmed mild COVID-19 at high risk of disease progression or moderate COVID-19. Patients were hospitalised and treated with regdanvimab (40 mg/kg, day 1) and then monitored until discharge, with a follow-up call on day 28. Adverse events (AEs) were documented, and the COVID-19 disease progression rate was used to measure effectiveness.

Results

Of the 3123 patients with COVID-19 infection identified, 3036 were eligible for inclusion. Approximately 80% and 5% of the eligible patients were diagnosed with COVID-19 during the delta- and omicron-dominant periods, respectively. Median (range) age was 57 (18–95) years, and 50.6% of patients were male. COVID-19 severity was assessed before treatment, and high-risk mild and moderate COVID-19 was diagnosed in 1030 (33.9%) and 2006 (66.1%) patients, respectively. AEs and adverse drug reactions (ADRs) were experienced by 684 (22.5%) and 363 (12.0%) patients, respectively. The most common ADR was increased liver function test (n = 62, 2.0%). Nine (0.3%) patients discontinued regdanvimab due to ADRs. Overall, 378 (12.5%) patients experienced disease progression after regdanvimab infusion, with extended hospitalisation/re-admission (n = 300, 9.9%) as the most common reason. Supplemental oxygen was required by 282 (9.3%) patients. Ten (0.3%) patients required intensive care monitoring and 3 (0.1%) died due to COVID-19.

Conclusion

This large-scale PMS study demonstrated that regdanvimab was effective against COVID-19 progression and had an acceptable safety profile when used in real-world clinical practice.
Appendix
Available only for authorised users
Literature
2.
go back to reference Fernandes Q, Inchakalody VP, Merhi M, et al. Emerging COVID-19 variants and their impact on SARS-CoV-2 diagnosis, therapeutics and vaccines. Ann Med. 2022;54:524–40.PubMedPubMedCentralCrossRef Fernandes Q, Inchakalody VP, Merhi M, et al. Emerging COVID-19 variants and their impact on SARS-CoV-2 diagnosis, therapeutics and vaccines. Ann Med. 2022;54:524–40.PubMedPubMedCentralCrossRef
6.
go back to reference Forman R, Shah S, Jeurissen P, Jit M, Mossialos E. COVID-19 vaccine challenges: what have we learned so far and what remains to be done? Health Policy. 2021;125:553–67.PubMedPubMedCentralCrossRef Forman R, Shah S, Jeurissen P, Jit M, Mossialos E. COVID-19 vaccine challenges: what have we learned so far and what remains to be done? Health Policy. 2021;125:553–67.PubMedPubMedCentralCrossRef
7.
go back to reference Liu M, Gan H, Liang Z, et al. Review of therapeutic mechanisms and applications based on SARS-CoV-2 neutralizing antibodies. Front Microbiol. 2023;14:1122868.PubMedPubMedCentralCrossRef Liu M, Gan H, Liang Z, et al. Review of therapeutic mechanisms and applications based on SARS-CoV-2 neutralizing antibodies. Front Microbiol. 2023;14:1122868.PubMedPubMedCentralCrossRef
9.
go back to reference Wynia MK, Beaty LE, Bennett TD, et al. Real-world evidence of neutralizing monoclonal antibodies for preventing hospitalization and mortality in COVID-19 outpatients. Chest. 2023;163:1061–70.PubMedCrossRef Wynia MK, Beaty LE, Bennett TD, et al. Real-world evidence of neutralizing monoclonal antibodies for preventing hospitalization and mortality in COVID-19 outpatients. Chest. 2023;163:1061–70.PubMedCrossRef
10.
go back to reference Deng J, Heybati K, Ramaraju HB, Zhou F, Rayner D, Heybati S. Differential efficacy and safety of anti-SARS-CoV-2 antibody therapies for the management of COVID-19: a systematic review and network meta-analysis. Infection. 2023;51:21–35.PubMedCrossRef Deng J, Heybati K, Ramaraju HB, Zhou F, Rayner D, Heybati S. Differential efficacy and safety of anti-SARS-CoV-2 antibody therapies for the management of COVID-19: a systematic review and network meta-analysis. Infection. 2023;51:21–35.PubMedCrossRef
11.
go back to reference Seo JM, Kang B, Song R, et al. Preclinical assessment and randomized Phase I study of CT-P63, a broadly neutralizing antibody targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Emerg Microbes Infect. 2022;11:2315–25.PubMedPubMedCentralCrossRef Seo JM, Kang B, Song R, et al. Preclinical assessment and randomized Phase I study of CT-P63, a broadly neutralizing antibody targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Emerg Microbes Infect. 2022;11:2315–25.PubMedPubMedCentralCrossRef
12.
13.
go back to reference Chinta S, Rodriguez-Guerra M, Shaban M, Pandey N, Jaquez-Duran M, Vittorio TJ. COVID-19 therapy and vaccination: a clinical narrative review. Drugs Context. 2023;12:2022-7–2.PubMedPubMedCentralCrossRef Chinta S, Rodriguez-Guerra M, Shaban M, Pandey N, Jaquez-Duran M, Vittorio TJ. COVID-19 therapy and vaccination: a clinical narrative review. Drugs Context. 2023;12:2022-7–2.PubMedPubMedCentralCrossRef
14.
go back to reference Kim C, Ryu DK, Lee J, et al. A therapeutic neutralizing antibody targeting receptor binding domain of SARS-CoV-2 spike protein. Nat Commun. 2021;12:288.PubMedPubMedCentralCrossRef Kim C, Ryu DK, Lee J, et al. A therapeutic neutralizing antibody targeting receptor binding domain of SARS-CoV-2 spike protein. Nat Commun. 2021;12:288.PubMedPubMedCentralCrossRef
15.
16.
go back to reference Das NC, Chakraborty P, Bayry J, Mukherjee S. In silico analyses on the comparative potential of therapeutic human monoclonal antibodies against newly emerged SARS-CoV-2 variants bearing mutant spike protein. Front Immunol. 2021;12: 782506.PubMedCrossRef Das NC, Chakraborty P, Bayry J, Mukherjee S. In silico analyses on the comparative potential of therapeutic human monoclonal antibodies against newly emerged SARS-CoV-2 variants bearing mutant spike protein. Front Immunol. 2021;12: 782506.PubMedCrossRef
17.
go back to reference Ryu DK, Kang B, Noh H, et al. The in vitro and in vivo efficacy of CT-P59 against Gamma, Delta and its associated variants of SARS-CoV-2. Biochem Biophys Res Commun. 2021;578:91–6.PubMedPubMedCentralCrossRef Ryu DK, Kang B, Noh H, et al. The in vitro and in vivo efficacy of CT-P59 against Gamma, Delta and its associated variants of SARS-CoV-2. Biochem Biophys Res Commun. 2021;578:91–6.PubMedPubMedCentralCrossRef
18.
20.
go back to reference Kim JY, Săndulescu O, Preotescu LL, et al. A randomized clinical trial of regdanvimab in high-risk patients with mild-to-moderate coronavirus disease 2019. Open Forum Infect Dis. 2022;9:ofac406.PubMedPubMedCentralCrossRef Kim JY, Săndulescu O, Preotescu LL, et al. A randomized clinical trial of regdanvimab in high-risk patients with mild-to-moderate coronavirus disease 2019. Open Forum Infect Dis. 2022;9:ofac406.PubMedPubMedCentralCrossRef
21.
go back to reference Streinu-Cercel A, Săndulescu O, Preotescu LL, et al. Efficacy and safety of regdanvimab (CT-P59): a phase 2/3 randomized, double-blind, placebo-controlled trial in outpatients with mild-to-moderate coronavirus disease 2019. Open Forum Infect Dis. 2022;9:ofac053.PubMedPubMedCentralCrossRef Streinu-Cercel A, Săndulescu O, Preotescu LL, et al. Efficacy and safety of regdanvimab (CT-P59): a phase 2/3 randomized, double-blind, placebo-controlled trial in outpatients with mild-to-moderate coronavirus disease 2019. Open Forum Infect Dis. 2022;9:ofac053.PubMedPubMedCentralCrossRef
25.
go back to reference Jang YR, Oh YJ, Kim JY. Clinical effectiveness of regdanvimab treatment for mild-to-moderate COVID-19: a retrospective cohort study. Curr Ther Res Clin Exp. 2022;96:100675.PubMedPubMedCentralCrossRef Jang YR, Oh YJ, Kim JY. Clinical effectiveness of regdanvimab treatment for mild-to-moderate COVID-19: a retrospective cohort study. Curr Ther Res Clin Exp. 2022;96:100675.PubMedPubMedCentralCrossRef
26.
go back to reference Lee S, Lee SO, Lee JE, et al. Regdanvimab in patients with mild-to-moderate SARS-CoV-2 infection: a propensity score-matched retrospective cohort study. Int Immunopharmacol. 2022;106:108570.PubMedPubMedCentralCrossRef Lee S, Lee SO, Lee JE, et al. Regdanvimab in patients with mild-to-moderate SARS-CoV-2 infection: a propensity score-matched retrospective cohort study. Int Immunopharmacol. 2022;106:108570.PubMedPubMedCentralCrossRef
27.
go back to reference Park S, Je NK, Kim DW, Park M, Heo J. Effectiveness and safety of regdanvimab in patients with mild-to-moderate COVID-19: a retrospective cohort study. J Korean Med Sci. 2022;37:e102.PubMedPubMedCentralCrossRef Park S, Je NK, Kim DW, Park M, Heo J. Effectiveness and safety of regdanvimab in patients with mild-to-moderate COVID-19: a retrospective cohort study. J Korean Med Sci. 2022;37:e102.PubMedPubMedCentralCrossRef
28.
go back to reference Choi SJ, Park SW, Lee E. Effectiveness of regdanvimab at preventing the need for oxygen therapy in patients with mild-to-moderate COVID-19: a retrospective cohort study. Infect Chemother. 2022;54:91–101.PubMedPubMedCentralCrossRef Choi SJ, Park SW, Lee E. Effectiveness of regdanvimab at preventing the need for oxygen therapy in patients with mild-to-moderate COVID-19: a retrospective cohort study. Infect Chemother. 2022;54:91–101.PubMedPubMedCentralCrossRef
29.
go back to reference Kim T, Joo DH, Lee SW, Lee J, Lee SJ, Kang J. Real-world efficacy of regdanvimab on clinical outcomes in patients with mild to moderate COVID-19. J Clin Med. 2022;11:1412 Kim T, Joo DH, Lee SW, Lee J, Lee SJ, Kang J. Real-world efficacy of regdanvimab on clinical outcomes in patients with mild to moderate COVID-19. J Clin Med. 2022;11:1412
30.
go back to reference Hong SI, Ryu BH, Hong KW, Bae IG, Cho OH. Real world experience with regdanvimab treatment of mild-to-moderate coronavirus disease-19 in a COVID-19 designated hospital of Korea. Infect Chemother. 2022;54:114–24.PubMedPubMedCentralCrossRef Hong SI, Ryu BH, Hong KW, Bae IG, Cho OH. Real world experience with regdanvimab treatment of mild-to-moderate coronavirus disease-19 in a COVID-19 designated hospital of Korea. Infect Chemother. 2022;54:114–24.PubMedPubMedCentralCrossRef
31.
go back to reference Kwak YG, Song JE, Kang J, et al. Use of the monoclonal antibody regdanvimab to treat patients hospitalized with COVID-19: real-world data during the Delta variant predominance. Infect Chemother. 2022;54:781–6.PubMedPubMedCentralCrossRef Kwak YG, Song JE, Kang J, et al. Use of the monoclonal antibody regdanvimab to treat patients hospitalized with COVID-19: real-world data during the Delta variant predominance. Infect Chemother. 2022;54:781–6.PubMedPubMedCentralCrossRef
32.
go back to reference Lee JY, Lee JY, Ko JH, et al. Effectiveness of regdanvimab treatment in high-risk COVID-19 patients to prevent progression to severe disease. Front Immunol. 2021;12:772320.PubMedPubMedCentralCrossRef Lee JY, Lee JY, Ko JH, et al. Effectiveness of regdanvimab treatment in high-risk COVID-19 patients to prevent progression to severe disease. Front Immunol. 2021;12:772320.PubMedPubMedCentralCrossRef
33.
34.
go back to reference Beaulieu-Jones BK, Finlayson SG, Yuan W, et al. Examining the use of real-world evidence in the regulatory process. Clin Pharmacol Ther. 2020;107:843–52.PubMedCrossRef Beaulieu-Jones BK, Finlayson SG, Yuan W, et al. Examining the use of real-world evidence in the regulatory process. Clin Pharmacol Ther. 2020;107:843–52.PubMedCrossRef
35.
go back to reference Song H, Yim DS. Problems within the post-marketing surveillance system in Korea: time for a change. Transl Clin Pharmacol. 2016;24:63–5.CrossRef Song H, Yim DS. Problems within the post-marketing surveillance system in Korea: time for a change. Transl Clin Pharmacol. 2016;24:63–5.CrossRef
39.
go back to reference Kim I, Park A, Lee H, et al. Status and characteristics of the SARS-CoV-2 variant outbreak in the Republic of Korea in January 2021. Public Health Wkly Rep. 2022;15:505–10. Kim I, Park A, Lee H, et al. Status and characteristics of the SARS-CoV-2 variant outbreak in the Republic of Korea in January 2021. Public Health Wkly Rep. 2022;15:505–10.
40.
go back to reference Raj N, Fernandes S, Charyulu NR, Dubey A, G SR, Hebbar S. Postmarket surveillance: a review on key aspects and measures on the effective functioning in the context of the United Kingdom and Canada. Ther Adv Drug Saf. 2019;10:2042098619865413. Raj N, Fernandes S, Charyulu NR, Dubey A, G SR, Hebbar S. Postmarket surveillance: a review on key aspects and measures on the effective functioning in the context of the United Kingdom and Canada. Ther Adv Drug Saf. 2019;10:2042098619865413.
41.
go back to reference Younus MM, Al-Jumaili AA. An overview of COVID-19 vaccine safety and post-marketing surveillance systems. Innov Pharm. 2021;1210.24926/iip.v12i4.4294. Younus MM, Al-Jumaili AA. An overview of COVID-19 vaccine safety and post-marketing surveillance systems. Innov Pharm. 2021;1210.24926/iip.v12i4.4294.
42.
go back to reference Doessegger L, Banholzer ML. Clinical development methodology for infusion-related reactions with monoclonal antibodies. Clin Transl Immunol. 2015;4:e39.CrossRef Doessegger L, Banholzer ML. Clinical development methodology for infusion-related reactions with monoclonal antibodies. Clin Transl Immunol. 2015;4:e39.CrossRef
43.
go back to reference Herman GA, O’Brien MP, Forleo-Neto E, et al. Efficacy and safety of a single dose of casirivimab and imdevimab for the prevention of COVID-19 over an 8-month period: a randomised, double-blind, placebo-controlled trial. Lancet Infect Dis. 2022;22:1444–54.PubMedPubMedCentralCrossRef Herman GA, O’Brien MP, Forleo-Neto E, et al. Efficacy and safety of a single dose of casirivimab and imdevimab for the prevention of COVID-19 over an 8-month period: a randomised, double-blind, placebo-controlled trial. Lancet Infect Dis. 2022;22:1444–54.PubMedPubMedCentralCrossRef
44.
go back to reference Gottlieb RL, Nirula A, Chen P, et al. Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial. JAMA. 2021;325:632–44.PubMedPubMedCentralCrossRef Gottlieb RL, Nirula A, Chen P, et al. Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial. JAMA. 2021;325:632–44.PubMedPubMedCentralCrossRef
45.
go back to reference Goldin L, Elders T, Werhane L, Korwek K, Poland R, Guy J. Reactions and COVID-19 disease progression following SARS-CoV-2 monoclonal antibody infusion. Int J Infect Dis. 2021;112:73–5.PubMedPubMedCentralCrossRef Goldin L, Elders T, Werhane L, Korwek K, Poland R, Guy J. Reactions and COVID-19 disease progression following SARS-CoV-2 monoclonal antibody infusion. Int J Infect Dis. 2021;112:73–5.PubMedPubMedCentralCrossRef
46.
go back to reference Zou J, Jing F. Cardiovascular adverse events associated with monoclonal antibody products in patients with COVID-19. Pharmaceuticals (Basel). 2022;15:1472.PubMedCrossRef Zou J, Jing F. Cardiovascular adverse events associated with monoclonal antibody products in patients with COVID-19. Pharmaceuticals (Basel). 2022;15:1472.PubMedCrossRef
47.
go back to reference Montastruc F, Lafaurie M, Flumian C, de Canecaude C. Increased reporting of venous and arterial thromboembolic events reported with tixagevimab-cilgavimab for coronavirus disease 2019. Clin Microbiol Infect. 2023;29:543.e1–3.CrossRef Montastruc F, Lafaurie M, Flumian C, de Canecaude C. Increased reporting of venous and arterial thromboembolic events reported with tixagevimab-cilgavimab for coronavirus disease 2019. Clin Microbiol Infect. 2023;29:543.e1–3.CrossRef
48.
go back to reference Yang M, Li A, Jiang L, Wang Y, Tran C, Ao G. Regdanvimab improves disease mortality and morbidity in patients with COVID-19: a meta-analysis. J Infect. 2022;85:e122–4.PubMedPubMedCentralCrossRef Yang M, Li A, Jiang L, Wang Y, Tran C, Ao G. Regdanvimab improves disease mortality and morbidity in patients with COVID-19: a meta-analysis. J Infect. 2022;85:e122–4.PubMedPubMedCentralCrossRef
49.
go back to reference Kadowaki T, Imajou S, Matsumoto N, Takao S, Yorifuji T. Timing of REGEN-COV administration and progression to severe COVID-19. J Infect Chemother. 2022;28:1459–63.PubMedPubMedCentralCrossRef Kadowaki T, Imajou S, Matsumoto N, Takao S, Yorifuji T. Timing of REGEN-COV administration and progression to severe COVID-19. J Infect Chemother. 2022;28:1459–63.PubMedPubMedCentralCrossRef
51.
go back to reference Jang YR, Oh YJ, Kim JY. Regdanvimab for patients with mild-to-moderate COVID-19: a retrospective cohort study and subgroup analysis of patients with the Delta variant. Int J Infect Dis. 2023;130:94–100.PubMedPubMedCentralCrossRef Jang YR, Oh YJ, Kim JY. Regdanvimab for patients with mild-to-moderate COVID-19: a retrospective cohort study and subgroup analysis of patients with the Delta variant. Int J Infect Dis. 2023;130:94–100.PubMedPubMedCentralCrossRef
52.
go back to reference Razonable RR, O’Horo JC, Challener DW, et al. Curbing the Delta surge: clinical outcomes after treatment with bamlanivimab-etesevimab, casirivimab-imdevimab, or sotrovimab for mild to moderate coronavirus disease 2019. Mayo Clin Proc. 2022;97:1641–8.PubMedCrossRef Razonable RR, O’Horo JC, Challener DW, et al. Curbing the Delta surge: clinical outcomes after treatment with bamlanivimab-etesevimab, casirivimab-imdevimab, or sotrovimab for mild to moderate coronavirus disease 2019. Mayo Clin Proc. 2022;97:1641–8.PubMedCrossRef
53.
go back to reference Kip KE, McCreary EK, Collins K, et al. Evolving real-world effectiveness of monoclonal antibodies for treatment of COVID-19: a cohort study. Ann Intern Med. 2023;176:496–504.PubMedCrossRef Kip KE, McCreary EK, Collins K, et al. Evolving real-world effectiveness of monoclonal antibodies for treatment of COVID-19: a cohort study. Ann Intern Med. 2023;176:496–504.PubMedCrossRef
54.
go back to reference Planas D, Saunders N, Maes P, et al. Considerable escape of SARS-CoV-2 Omicron to antibody neutralization. Nature. 2022;602:671–5.PubMedCrossRef Planas D, Saunders N, Maes P, et al. Considerable escape of SARS-CoV-2 Omicron to antibody neutralization. Nature. 2022;602:671–5.PubMedCrossRef
56.
go back to reference VanBlargan LA, Errico JM, Halfmann PJ, et al. An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by therapeutic monoclonal antibodies. Nat Med. 2022;28:490–5.PubMedPubMedCentralCrossRef VanBlargan LA, Errico JM, Halfmann PJ, et al. An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by therapeutic monoclonal antibodies. Nat Med. 2022;28:490–5.PubMedPubMedCentralCrossRef
Metadata
Title
Safety and Effectiveness of Regdanvimab for COVID-19 Treatment: A Phase 4 Post-marketing Surveillance Study Conducted in South Korea
Authors
Ji Yeon Lee
Seon Hee Bu
EunHyang Song
Seongcheol Cho
Sungbong Yu
Jungok Kim
Sungmin Kym
Kwang Won Seo
Ki Tae Kwon
Jin Yong Kim
Sunghyun Kim
Keumyoung Ahn
Nahyun Jung
Yeonmi Lee
Yoobin Jung
Chankyoung Hwang
Sang Won Park
Publication date
13-10-2023
Publisher
Springer Healthcare
Published in
Infectious Diseases and Therapy / Issue 10/2023
Print ISSN: 2193-8229
Electronic ISSN: 2193-6382
DOI
https://doi.org/10.1007/s40121-023-00859-1

Other articles of this Issue 10/2023

Infectious Diseases and Therapy 10/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine