Casirivimab and imdevimab



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Drug updated on 5/17/2024

Dosage FormInjection (intravenous; 600 mg)
Drug ClassRecombinant human monoclonal antibodies (mAbs)
Ongoing and
Completed Studies


  • Indicated for the treatment of mild to moderate coronavirus disease 2019 (COVID-19) in adult and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death.

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  • Casirivimab and imdevimab (REGEN-COV) are used for the treatment of mild to moderate COVID-19 in adult and pediatric patients who have tested positive for SARS-CoV-2, particularly those at high risk for severe disease progression.
  • Fourteen systematic reviews/meta-analyses provided information on the safety, effectiveness, comparisons with other treatments, and subgroup considerations related to casirivimab and imdevimab.
  • The drug combination significantly reduces mortality rates and clinical symptom progression in COVID-19 patients while also facilitating viral load clearance.
  • For pregnant women specifically, treatment with casirivimab/imdevimab has been shown to decrease the need for cesarean sections without significant impact on other pregnancy-related outcomes or disease progression.
  • Compared to anti-SARS-CoV antibody regimens such as bamlanivimab alone or combined with etesevimab, casirivimab/imdevimab was ranked among treatments that notably reduced mortality, especially in baseline seronegative patients.
  • Studies indicate that tocilizumab shows statistically favorable outcomes compared to standard care when treating severe cases of COVID-19. This highlights the need for careful consideration of patient risk factors before administering monoclonal antibodies like REGEN-COV.
  • The use of this medication is associated with a reduction in hospitalization risks among high-risk infected individuals, potentially reducing ICU admission rates and invasive ventilation rates, albeit uncertainties exist around these findings.
  • In terms of subgroup considerations, it's important to note that more focused research is needed within specific subgroups such as pregnant women, where no significant effect was observed regarding disease progression despite noted prevention against cesarean sections by CAS/IMD. Also, considering patients’ serostatus prior to administering monoclonal antibodies for COVID-19 is crucial.

Product Monograph / Prescribing Information

Document TitleYearSource
REGEN-COV (casirivimab and imdevimab) Prescribing Information.2022Regeneron Pharmaceuticals, Inc., Tarrytown, NY

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Effects of bamlanivimab alone or in combination with etesevimab on subsequent hospitalization and mortality in outpatients with COVID-19: a systematic review and meta-analysis.2023PeerJ
Efficacy and safety of casirivimab-imdevimab combination on COVID-19 patients: a systematic review and meta-analysis randomized controlled trial.2023Heliyon
Efficacy and safety of therapies for COVID-19 in pregnancy: a systematic review and meta-analysis.2023BMC Infectious Diseases
Assessment of the available therapeutic approaches for severe COVID-19: a meta-analysis of randomized controlled trials.2023Scientific Reports
Casirivimab-imdevimab treatment is associated with reduced rates of mortality and hospitalization in patients with COVID-19: a systematic review with meta-analysis.2023Journal of Infection
Efficacy and safety of anti-sars-cov-2 monoclonal antibodies: an updated review.2023Monoclonal Antibodies in Immunodiagnosis and Immunotherapy
Differential efficacy and safety of anti-SARS-CoV-2 antibody therapies for the management of COVID-19: a systematic review and network meta-analysis.2023Infection
Comparative effectiveness of neutralising monoclonal antibodies in high risk COVID-19 patients: a Bayesian network meta-analysis.2022Scientific Reports
Susceptibility of sars-cov-2 omicron variants to therapeutic monoclonal antibodies: systematic review and meta-analysis.2022Microbiology Spectrum
SARS-CoV-2-neutralising monoclonal antibodies to prevent COVID-19.2022The Cochrane Database of Systematic Reviews
Interventions in an ambulatory setting to prevent progression to severe disease in patients with COVID-19: a systematic review.2022Annals of Pharmacotherapy
A systematic review assessing the underrepresentation of cancer patients in COVID-19 trials.2022Acta Haemotologica
Antibody and cellular therapies for treatment of COVID-19: a living systematic review and network meta-analysis.2022BMJ Open
SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19.2022The Cochrane Database of Systematic Reviews
Beneficial and harmful effects of monoclonal antibodies for the treatment and prophylaxis of COVID-19: systematic review and meta-analysis.2021The American Journal of Medicine

Clinical Practice Guidelines