Real-world Effect of Monoclonal Antibody Treatment in COVID-19 Patients in a Diverse Population in the United States

Background: Monoclonal antibodies (mAbs) against SARS-CoV-2 are a promising treatment for limiting the progression of COVID-19 and decreasing strain on hospitals. Their use, however, remains limited, particularly in disadvantaged populations. Methods: Electronic health records were reviewed from SARS-CoV-2 patients at a single medical center in the United States that initiated mAb infusions in January 2021 with the support of the U.S. Department of Health and Human Services' National Disaster Medical System. Patients who received mAbs were compared to untreated patients from the time period before mAb availability who met eligibility criteria for mAb treatment. We used logistic regression to measure the effect of mAb treatment on the risk of hospitalization or emergency department (E.D.) visit within 30 days of laboratory-confirmed COVID-19. Results: Of 598 COVID-19 patients, 270 (45%) received bamlanivimab and 328 (55%) were untreated. Two hundred and thirty-one patients (39%) were Hispanic. Among treated patients, 5/270 (1.9%) presented to the E.D. or required hospitalization within 30 days of a positive SARS-CoV-2 test, compared to 39/328 (12%) untreated patients (p<0.001). After adjusting for age, gender, and comorbidities, the risk of E.D. visit or hospitalization was 82% lower in mAb-treated patients compared to untreated patients (95% confidence interval [CI]: 66%-94%). Conclusions: In this diverse, real-world COVID-19 patient population, mAb treatment significantly decreased the risk of subsequent E.D. visit or hospitalization. Broader treatment with mAbs, including in disadvantaged patient populations, can decrease the burden on hospitals and should be facilitated in all populations in the United States to ensure health equity.

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Real-world Effect of Monoclonal Antibody Treatment in COVID-19 Patients in a Diverse Population in the United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab398 ◽

2021 ◽

Author(s):

Kaitlin Rainwater-Lovett ◽

John T Redd ◽

Miles A Stewart ◽

Natalia Elías Calles ◽

Tyler Cluff ◽

...

Keyword(s):

United States ◽

Real World ◽

Medical Center ◽

The United States ◽

Antibody Treatment ◽

Eligibility Criteria ◽

Department Of Health ◽

Time Period ◽

Monoclonal Antibody Treatment ◽

National Disaster

Abstract Background Monoclonal antibodies (mAbs) against SARS-CoV-2 are a promising treatment for limiting the progression of COVID-19 and decreasing strain on hospitals. Their use, however, remains limited, particularly in disadvantaged populations. Methods Electronic health records were reviewed from SARS-CoV-2 patients at a single medical center in the United States that initiated mAb infusions in January 2021 with the support of the U.S. Department of Health and Human Services’ National Disaster Medical System. Patients who received mAbs were compared to untreated patients from the time period before mAb availability who met eligibility criteria for mAb treatment. We used logistic regression to measure the effect of mAb treatment on the risk of hospitalization or emergency department (E.D.) visit within 30 days of laboratory-confirmed COVID-19. Results Of 598 COVID-19 patients, 270 (45%) received bamlanivimab and 328 (55%) were untreated. Two hundred and thirty-one patients (39%) were Hispanic. Among treated patients, 5/270 (1.9%) presented to the E.D. or required hospitalization within 30 days of a positive SARS-CoV-2 test, compared to 39/328 (12%) untreated patients (p<0.001). After adjusting for age, gender, and comorbidities, the risk of E.D. visit or hospitalization was 82% lower in mAb-treated patients compared to untreated patients (95% confidence interval [CI]: 56%-94%). Conclusions In this diverse, real-world COVID-19 patient population, mAb treatment significantly decreased the risk of subsequent E.D. visit or hospitalization. Broader treatment with mAbs, including in disadvantaged patient populations, can decrease the burden on hospitals and should be facilitated in all populations in the United States to ensure health equity.

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Pricing Initial Audit Engagements: A Test of Competing Theories

The Accounting Review ◽

10.2308/accr.1999.74.2.201 ◽

1999 ◽

Vol 74 (2) ◽

pp. 201-216 ◽

Cited By ~ 157

Author(s):

Allen T. Craswell ◽

Jere R. Francis

Keyword(s):

United States ◽

Product Quality ◽

Audit Fees ◽

The United States ◽

Public Disclosure ◽

Audit Pricing ◽

Experience Goods ◽

Economic Theories ◽

Time Period

Two competing theories of initial engagement audit pricing are examined empirically. DeAngelo's (1981a) model predicts initial engagement discounts in all settings, while Dye's (1991) model specifically predicts discounting will not occur in settings where audit fees are publicly disclosed. Unlike the United States and most countries, audit fees are publicly disclosed in Australia. Our study examines initial engagement pricing in Australia during a time period when comparable U.S. studies report discounts of 25 percent (Ettredge and Greenberg 1990; Simon and Francis 1988). The Australian evidence finds initial engagement discounting only for upgrades from non-Big 8 to Big 8 auditors. Discounting for upgrades to Big 8 auditors is consistent with economic theories of discount pricing by sellers of higher-priced, higher-quality experience goods as an inducement to purchase when uncertainty about product quality is resolved through buying (experiencing) the goods. The evidence in our study is generally consistent with Dye's (1991) conclusion that public disclosure of audit fees precludes initial engagement discounting and the potential independence problems arising from such discounting.

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Fat as a Floating Signifier

The Oxford Handbook of the Sociology of Body and Embodiment ◽

10.1093/oxfordhb/9780190842475.013.9 ◽

2019 ◽

pp. 143-163

Author(s):

Sabrina Strings

Keyword(s):

United States ◽

Discourse Analysis ◽

The United States ◽

Anglo Saxon ◽

National Belonging ◽

Time Period ◽

Irish Women ◽

Stuart Hall ◽

Fat Phobia ◽

Fat Stigma

Studies on the development of fat stigma in the United States often consider gender, but not race. This chapter adds to the literature on the significance of race in the propagation of fat phobia. I investigate representations of voluptuousness among “white” Anglo-Saxon and German women, as well as “black” Irish women between 1830 and 1890—a time period during which the value of a curvy physique was hotly contested—performing a discourse analysis of thirty-three articles from top newspapers and magazines. I found that the rounded forms of Anglo-Saxon and German women were generally praised as signs of health and beauty. The fat Irish, by contrast, were depicted as grotesque. Building on the work of Stuart Hall, I conclude that fat was a “floating signifier” of race and national belonging. That is, rather than being universally lauded or condemned, the value attached to fatness was related to the race of its possessor.

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116P Real-world treatment patterns and clinical effectiveness of eribulin in HR+/HER2- metastatic breast cancer patients in the United States

Annals of Oncology ◽

10.1016/j.annonc.2021.03.130 ◽

2021 ◽

Vol 32 ◽

pp. S72

Author(s):

S.S. Mougalian ◽

J. Zhang ◽

J.K. Kish ◽

M.E. Zettler ◽

B.A. Feinberg

Keyword(s):

Breast Cancer ◽

United States ◽

Metastatic Breast Cancer ◽

Cancer Patients ◽

Real World ◽

Metastatic Breast ◽

Clinical Effectiveness ◽

The United States ◽

Treatment Patterns ◽

Breast Cancer Patients

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Real-World Treatment Patterns and Outcomes Among Multiple Myeloma Patients with Asthma and COPD in the United States

Oncology and Therapy ◽

10.1007/s40487-021-00146-4 ◽

2021 ◽

Author(s):

Megan S. Rice ◽

Sarah Naeger ◽

Erin Singh

Keyword(s):

United States ◽

Multiple Myeloma ◽

Real World ◽

The United States ◽

Treatment Patterns

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Efficacy and Safety of Lenvatinib Therapy for Unresectable Hepatocellular Carcinoma in a Real-World Practice in Korea

Liver Cancer ◽

10.1159/000512239 ◽

2021 ◽

pp. 1-11

Author(s):

Myung Ji Goh ◽

Joo Hyun Oh ◽

Yewan Park ◽

Jihye Kim ◽

Wonseok Kang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Prognostic Factors ◽

Disease Progression ◽

Real World ◽

Medical Center ◽

Objective Response ◽

Progression Free Survival ◽

Efficacy And Safety ◽

Eligibility Criteria ◽

Unresectable Hepatocellular Carcinoma

Background: Lenvatinib has been recently approved as a first-line treatment option for patients with unresectable hepatocellular carcinoma (HCC) in Korea. We aimed to study the efficacy and safety of lenvatinib therapy in a real-world practice and to find prognostic factors related to survival and disease progression. Methods: A hospital-based retrospective study was conducted on 111 consecutive patients who had unresectable HCC and were treated with lenvatinib at Samsung Medical Center from October 2018 to March 2020. Efficacy was determined using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria in 111 patients who completed 1st tumor assessment. Safety was evaluated in 116 HCC patients including 5 patients who discontinued lenvatinib due to adverse events (AEs) before 1st tumor assessment using Common Terminology Criteria for AEs version 5.0. Results: A total of 111 patients with a median age of 59 years were analyzed during a median follow-up duration of 6.2 (4.4–9.0) months. The Kaplan-Meier estimate of overall survival was 10.5 months, and the median progression-free survival was 6.2 months. Based on mRECIST criteria, the objective response rate was 18.9% and disease control rate was 75.7%. AEs developed in 86/116 (74.1%) patients, and grade ≥3 AEs developed in 16/116 (13.8%) patients. Diarrhea, hand-foot skin rash, abdominal pain, hypertension, and anorexia were identified as the AEs with the highest frequencies of any grade. REFLECT eligibility criteria including tumor extent ≥50% liver occupation or inadequate bone marrow function and occurrence of anorexia were prognostic factors for survival, and occurrence of diarrhea was a favorable factor for disease progression. Conclusion: Lenvatinib therapy showed a favorable efficacy and safety in a real-world practice. The REFLECT eligibility criteria and specific AEs could be one of the prognostic markers.

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