[Skip to Content]
[Skip to Content Landing]

Outcome Comparison of High-Risk Native American Patients Who Did or Did Not Receive Monoclonal Antibody Treatment for COVID-19

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Treatments for COVID-19 remain urgent and necessary despite increasing vaccine distribution. Studies suggest that monoclonal antibody (mAb) therapies prevent progression in early disease.1,2 In late 2020, the US Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for 2 mAb therapies, bamlanivimab and a combination of casirivimab and imdevimab, to treat COVID-19.3,4 However, previous mAb studies1,2 with a total of 852 participants (577 in one study1 and 275 in the other2) did not report a reduction in patient mortality, and only 5 participants across both trials (0.6%) were Native American. We present a retrospective quality improvement study on an early mAb treatment program for high-risk Native American patients at the Whiteriver Service Unit (WRSU), a rural acute care facility that serves as the primary hospital and public health department on the Fort Apache Indian Reservation in eastern Arizona.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: July 19, 2021.

Published: September 21, 2021. doi:10.1001/jamanetworkopen.2021.25866

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Close RM et al. JAMA Network Open.

Corresponding Author: Ryan M. Close, MD, MPH, Whiteriver Indian Hospital, Indian Health Service, 200 W Hospital Dr, PO Box 860, Whiteriver, AZ 85941 (ryan.close@ihs.gov).

Author Contributions: Dr Close had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr Close and Mr Jones contributed equally to the work.

Concept and design: Close, Jones, McAuley.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Close, Jones, Jentoft.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Close, Jones.

Administrative, technical, or material support: All authors.

Supervision: Close, McAuley.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank LCDR Trevor Thompson, PharmD, BCPS, Whiteriver Service Unit, for support in data collection and aggregation. LCDR Thompson did not receive any compensation.

References
1.
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(7):632-644. doi:10.1001/jama.2021.0202 PubMedGoogle ScholarCrossref
2.
Weinreich  DM , Sivapalasingam  S , Norton  T ,  et al; Trial Investigators.  REGN-COV2, a neutralizing antibody cocktail, in outpatients with COVID-19.   N Engl J Med. 2021;384(3):238-251. doi:10.1056/NEJMoa2035002 PubMedGoogle ScholarCrossref
3.
US Food and Drug Administration. Fact sheet for health care providers: emergency use authorization (EUA) of bamlanivimab and etesevimab. November 9, 2020. Updated May 14, 2021. Accessed January 29, 2021. https://www.fda.gov/media/145802/download
4.
US Food and Drug Administration. Fact sheet for health care providers: emergency use authorization (EUA) of REGEN-COV (casirivimab and imdevimab). November 21, 2020. Updated July 30, 2021. Accessed January 29, 2021. https://www.fda.gov/media/145611/download
5.
Cheek  JE , Holman  RC , Redd  JT , Haberling  D , Hennessy  TW .  Infectious disease mortality among American Indians and Alaska Natives, 1999-2009.   Am J Public Health. 2014;104(suppl 3):S446-S452. doi:10.2105/AJPH.2013.301721 PubMedGoogle ScholarCrossref
6.
Arrazola  J , Masiello  MM , Joshi  S ,  et al.  COVID-19 mortality among American Indian and Alaska Native persons—14 states, January-June 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(49):1853-1856. doi:10.15585/mmwr.mm6949a3 PubMedGoogle ScholarCrossref
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close
Close

Lookup An Activity

or

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close