• Several other therapeutic op tions exist f or patients with C OVID-19 across the se verity spectrum: see decision support t ool that displays benefits and harms o f nirmatrelvir-ritonavir, molnupiravir and remdesivir.
• The GDG c onsidered in vitro data demonstrating that c asirivimab-imdevimab does no t neutralize the curr ently circulating variants of SARS-CoV-2 and their sub variants.
• There was consensus among the panel that the meaningful r eduction o f in vitro neutralization activity str ongly sugg ests absenc e of clinical effectiveness o f monoclonal an tibodies such as so trovimab and c asirivimab-imdevimab.
• There was also c onsensus regarding the need f or clinical trial evidence in order to confirm clinical effectiveness o f new monoclonal antibodies that r eliably neutralize circulating strains in vitro.

Resources and other considerations Acceptability and feasibilty The strong recommendation against the use o f casirivimab-imdevimab is further supported b y the challenges with availability and feasibility, such as limited pr oduction, intravenous administration and requirement for expertise to offer such treatment while oral options are also available.