1198-P: Prevention of COVID-with Subcutaneous Administration of CAS+IMD in Individuals with Diabetes and Other Risk Factors for Severe Disease

Background: Subcutaneous (SC) administration of the monoclonal antibody combination casirivimab and imdevimab (CAS+IMD) decreased the risk of COVID-in a phase 3 trial of uninfected adolescents/adults who shared a household with a SARS-CoV-2–infected individual (NCT04452318) . Here, we present a subgroup analysis of this study, assessing the efficacy and safety of CAS+IMD in preventing symptomatic COVID-in individuals with diabetes and other risk factors for progression to severe disease. Methods: Healthy individuals aged ≥12 years, identified within 96 hours of collection of a positive test from a household contact, were randomized 1:1 to receive SC CAS+IMD 1200 mg or placebo. The primary endpoint was the proportion of participants who developed symptomatic COVID-during the 28-day efficacy assessment period among those who were SARS-CoV-2 RT-qPCR negative at baseline. Post hoc analyses assessed efficacy and safety by diabetes history, body mass index (BMI) , and the presence/absence of ≥1 high-risk factor for severe COVID-19. Results: The efficacy analysis included 2067 participants who were enrolled from July 13, 2020–January 28, 2021 and were RT-qPCR negative at baseline. In participants with diabetes (n=139) , the relative risk reduction (RRR) of developing symptomatic COVID-with CAS+IMD vs. placebo was 76.3%. Similar results were observed in participants with BMI ≥30 kg/m2 (n=728; RRR=74.9%) and in those with ≥1 high-risk factor for severe COVID-at baseline (n=620; RRR=77.5%) . Across subgroups, injection-site reaction was more common with CAS+IMD versus placebo whereas asymptomatic COVID-19, COVID-19, and headache were more common with placebo versus CAS+IMD. Conclusions: In study participants with diabetes and those with other risk factors for severe COVID-19, treatment with SC CAS+IMD decreased the risk of developing symptomatic COVID-19, consistent with results in the overall population.