Evidence map›Paper›PMID 34556486›Full record

SynthesisBMJ (Clinical research ed.)2021

Antibody and cellular therapies for treatment of covid-19: a living systematic review and network meta-analysis.

Reed Ac Siemieniuk, Jessica J Bartoszko, Juan Pablo Díaz Martinez, Elena Kum, Anila Qasim, Dena Zeraatkar, Ariel Izcovich, Sophia Mangala, Long Ge, Mi Ah Han and 26 more

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 14 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 14 syntheses or guidelines pooled it, 82 citations in OpenAlex.

  1. Pooled it
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  5. Hyperimmune immunoglobulin for people with COVID-19.The Cochrane database of systematic reviews · 2023
    Pooled it
  6. Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2023
    Pooled it
  7. Pooled it
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  9. Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2022
    Pooled it
  10. Guideline
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

36 authors at 15 institutions in 9 countries.

Reed Ac SiemieniukDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada reed.siemieniuk@medportal.ca.ORCID 0000-0002-3725-3031
Jessica J BartoszkoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Juan Pablo Díaz MartinezDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Elena KumDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Anila QasimDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Dena ZeraatkarDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Ariel IzcovichServicio de Clinica Médica del Hospital Alemán, Buenos Aires, Argentina.
Sophia MangalaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Long GeEvidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
Mi Ah HanDepartment of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea.
Thomas AgoritsasDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Donald ArnoldDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Camila ÁvilaEpistemonikos Foundation, Santiago, Chile.
Derek K ChuDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Rachel CoubanDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Ellen CusanoDepartment of Medicine, University of Calgary, Calgary, AB, Canada.
Andrea J DarziDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Tahira DevjiMedical school, University of Toronto, Toronto, ON, Canada.
Farid ForoutanTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Maryam GhadimiDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Assem KhamisWolfson Palliative Care Research Centre, Hull York Medical School, Hull, UK.
Francois LamontagneDepartment of Medicine and Centre de recherche du CHU de Sherbrooke, Sherbrooke, Quebec, Canada.
Mark LoebDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Anna MiroshnychenkoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Sharhzad MotaghiDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Srinivas MurthyDepartment of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver.
Reem A MustafaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Gabriel RadaEpistemonikos Foundation, Santiago, Chile.
Bram RochwergDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Charlotte SwitzerDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Per O VandvikInstitute of Health and Society, University of Oslo, Oslo, Norway.
Robin Wm VernooijDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, Netherlands.
Ying WangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Liang YaoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Gordon H GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
Romina Brignardello-Petersen
Impact · CAMcMaster University · CACentre Hospitalier Universitaire de Sherbrooke · CAChosun University · KRHospital Alemán · ARHull York Medical School · GBLanzhou University · CNUniversity Health Network · CAUniversity Hospital of Geneva · CHUniversity of British Columbia · CAUniversity of Calgary · CAUniversity of Kansas Medical Center · USUniversity of Oslo · NOUniversity of Toronto · CAUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the efficacy and safety of antiviral antibody therapies and blood products for the treatment of novel coronavirus disease 2019 (covid-19).

designLiving systematic review and network meta-analysis, with pairwise meta-analysis for outcomes with insufficient data. DATA SOURCES: WHO covid-19 database, a comprehensive multilingual source of global covid-19 literature, and six Chinese databases (up to 21 July 2021). STUDY SELECTION: Trials randomising people with suspected, probable, or confirmed covid-19 to antiviral antibody therapies, blood products, or standard care or placebo. Paired reviewers determined eligibility of trials independently and in duplicate.

methodsAfter duplicate data abstraction, we performed random effects bayesian meta-analysis, including network meta-analysis for outcomes with sufficient data. We assessed risk of bias using a modification of the Cochrane risk of bias 2.0 tool. The certainty of the evidence was assessed using the grading of recommendations assessment, development, and evaluation (GRADE) approach. We meta-analysed interventions with ≥100 patients randomised or ≥20 events per treatment arm.

resultsAs of 21 July 2021, we identified 47 trials evaluating convalescent plasma (21 trials), intravenous immunoglobulin (IVIg) (5 trials), umbilical cord mesenchymal stem cells (5 trials), bamlanivimab (4 trials), casirivimab-imdevimab (4 trials), bamlanivimab-etesevimab (2 trials), control plasma (2 trials), peripheral blood non-haematopoietic enriched stem cells (2 trials), sotrovimab (1 trial), anti-SARS-CoV-2 IVIg (1 trial), therapeutic plasma exchange (1 trial), XAV-19 polyclonal antibody (1 trial), CT-P59 monoclonal antibody (1 trial) and INM005 polyclonal antibody (1 trial) for the treatment of covid-19. Patients with non-severe disease randomised to antiviral monoclonal antibodies had lower risk of hospitalisation than those who received placebo: casirivimab-imdevimab (odds ratio (OR) 0.29 (95% CI 0.17 to 0.47); risk difference (RD) -4.2%; moderate certainty), bamlanivimab (OR 0.24 (0.06 to 0.86); RD -4.1%; low certainty), bamlanivimab-etesevimab (OR 0.31 (0.11 to 0.81); RD -3.8%; low certainty), and sotrovimab (OR 0.17 (0.04 to 0.57); RD -4.8%; low certainty). They did not have an important impact on any other outcome. There was no notable difference between monoclonal antibodies. No other intervention had any meaningful effect on any outcome in patients with non-severe covid-19. No intervention, including antiviral antibodies, had an important impact on any outcome in patients with severe or critical covid-19, except casirivimab-imdevimab, which may reduce mortality in patients who are seronegative.

conclusionIn patients with non-severe covid-19, casirivimab-imdevimab probably reduces hospitalisation; bamlanivimab-etesevimab, bamlanivimab, and sotrovimab may reduce hospitalisation. Convalescent plasma, IVIg, and other antibody and cellular interventions may not confer any meaningful benefit. SYSTEMATIC REVIEW REGISTRATION: This review was not registered. The protocol established a priori is included as a data supplement.

fundingThis study was supported by the Canadian Institutes of Health Research (grant CIHR- IRSC:0579001321). READERS' NOTE: This article is a living systematic review that will be updated to reflect emerging evidence. Interim updates and additional study data will be posted on our website (www.covid19lnma.com).

Indexed as

Antibodies, MonoclonalAntibodies, ViralAntiviral AgentsBayes TheoremCell- and Tissue-Based TherapyClinical Trials as TopicCOVID-19COVID-19 SerotherapyHumansImmunization, PassiveSARS-CoV-2Treatment OutcomeAntibodies, MonoclonalAntibodies, ViralAntiviral Agents

Identifiers

PMID34556486
PMCPMC8459162
OpenAlexW3200700398

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.