Clinical trial NCT04701658
Conditions: COVID-19
Sponsor: Eli Lilly and Company
Start date: 2021-02-01; Completion date: 2021-06-22
Enrollment: 109 participants; Allocation: NON_RANDOMIZED; Intervention model: PARALLEL

Brief summary:
The purpose of this study is to find out whether bamlanivimab is able to stop COVID-19 from getting worse. Participants with mild-to-moderate COVID-19 will receive bamlanivimab via an injection into a vein. These participants will be matched to similar COVID-19 patients who received other treatment at a local medical center. All participants will be followed to learn how their disease responds. Participation could last about 3 months and includes two required visits to the study site, with the remainder of assessments performed by phone or by medical record review.

Detailed description:

Arms: arm 1: Participants received 700 milligram single intravenous infusion of Bamlanivimab. arm 2: Matched controls who received standard of care.

\[The study was originally designed to include a matched control arm. However, due to low enrollment, it was amended to be a single arm study with Bamlanivimab arm only. No matched controls were utilized.\]
Interventions: intervention 1: Bamlanivimab
Intervention descriptions: intervention 1: Administered intravenously.

Protocol documents:
Prot_000.pdf: 
 
 
 
Protocol J2X-MC-PYAJ 
 
 
A prospective cohort study to evaluate the real-world effectiveness of 
bamlanivimab in participants with mild-to-moderate COVID-19 at 
high risk for progressing to severe illness, with matched controls. 
 
 
NCT04701658 
 
 
Approval Date: 18-Dec-2020 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
1
Title Page
Confidential Information
The information contained in this document is confidential and is intended for the use of clinical investigators. It is the property of 
Eli Lilly and Company or its subsidiaries and should not be copied by or distributed to persons not involved in the clinical 
investigation of bamlanivimab (LY3819253), unless such persons are bound by a confidentiality agreement with Eli Lilly and 
Company or its subsidiaries. 
Note to Regulatory Authorities: This document may contain protected personal data and/or commercially confidential information 
exempt from public disclosure. Eli Lilly and Company requests consultation regarding release/redaction prior to any public release. 
In the United States, this document is subject to Freedom of Information Act (FOIA) Exemption 4 and may not be reproduced or 
otherwise disseminated without the written approval of Eli Lilly and Company or its subsidiaries.
Protocol Title:
A prospective cohort study to evaluate the real-world effectiveness of bamlanivimab in 
participants with mild-to-moderate COVID-19 at high risk for progressing to severe illness, with 
matched controls
Protocol Number: J2X-MC-PYAJ
Compound(s): bamlanivimab (LY3819253)
Study Phase: 2
Short Title: A prospective cohort study to evaluate the effectiveness in the real-world setting of 
bamlanivimab in participants with mild-to-moderate COVID-19 at high risk for 
progressing to severe illness, with matched controls
Sponsor Name: Eli Lilly and Company
Legal Registered Address: Indianapolis, Indiana, USA 46285
Regulatory Agency Identifier Number(s):
IND: 150440
Approval Date: Protocol Electronically Signed and Approved by Lilly on date provided below.
Approval Date: 18-Dec-2020 GMT


CONFIDENTIAL
Protocol J2X-MC-PYAJ
2
Medical Monitor Name and Contact Information will be provided separately.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
3
Table of Contents
1.
Protocol Summary......................................................................................................6
1.1.
Synopsis.......................................................................................................................6
1.2.
Schema.........................................................................................................................9
1.3.
Schedule of Activities (SoA) ......................................................................................10
2.
Introduction..............................................................................................................13
2.1.
Study Rationale ..........................................................................................................13
2.2.
Background ................................................................................................................13
2.3.
Benefit/Risk Assessment ............................................................................................13
3.
Objectives and Endpoints.........................................................................................15
4.
Study Design .............................................................................................................16
4.1.
Overall Design............................................................................................................16
4.2.
Scientific Rationale for Study Design .........................................................................17
4.3.
Justification for Dose..................................................................................................18
4.4.
End of Study Definition..............................................................................................18
5.
Study Population ......................................................................................................19
5.1.
Inclusion Criteria........................................................................................................19
5.2.
Exclusion Criteria.......................................................................................................20
5.3.
Matched controls ........................................................................................................21
5.4.
Lifestyle Considerations .............................................................................................22
5.5.
Screen Failures...........................................................................................................22
6.
Study Intervention....................................................................................................23
6.1.
Study Intervention(s) Administered ............................................................................23
6.1.1.
Special Treatment Considerations...............................................................................23
6.1.2.
Temporary Stopping Criteria ......................................................................................24
6.2.
Preparation/Handling/Storage/Accountability.............................................................25
6.3.
Measures to Minimize Bias: Randomization and Blinding..........................................25
6.4.
Study Intervention Compliance...................................................................................25
6.5.
Concomitant Therapy .................................................................................................25
6.6.
Dose Modifications ....................................................................................................26
6.7.
Intervention after the End of the Study........................................................................26
7.
Discontinuation of Study Intervention and Participant 
Discontinuation/Withdrawal....................................................................................27
7.1.
Discontinuation of Study Intervention ........................................................................27
7.2.
Participant Discontinuation/Withdrawal from the Study .............................................27
7.2.1.
Discontinuation of Inadvertently Enrolled Participants ...............................................27
7.3.
Lost to Follow-Up ......................................................................................................28
8.
Study Assessments and Procedures .........................................................................29
8.1.
Efficacy Assessments .................................................................................................29
8.2.
Safety Assessments ....................................................................................................29
8.2.1.
Vital Signs..................................................................................................................29
8.2.2.
Hospitalization Events................................................................................................29
8.3.
Adverse Events and Serious Adverse Events ..............................................................30


CONFIDENTIAL
Protocol J2X-MC-PYAJ
4
8.3.1.
Time Period and Frequency for Collecting AE and SAE 
Information.................................................................................................................30
8.3.2.
Method of Detecting AEs and SAEs ...........................................................................30
8.3.3.
Follow-Up of AEs and SAEs ......................................................................................31
8.3.4.
Regulatory Reporting Requirements for SAEs............................................................31
8.3.5.
Pregnancy...................................................................................................................31
8.3.6.
Hypersensitivity Reactions .........................................................................................31
8.3.7.
Infusion-related Reactions ..........................................................................................31
8.3.8.
Product Complaints ....................................................................................................32
8.4.
Treatment of Overdose ...............................................................................................33
8.5.
Pharmacokinetics........................................................................................................33
8.6.
Pharmacodynamics.....................................................................................................33
8.7.
Genetics .....................................................................................................................33
8.8.
Biomarkers.................................................................................................................33
8.9.
Immunogenicity Assessments.....................................................................................33
8.10.
Health Economics.......................................................................................................33
9.
Statistical Considerations.........................................................................................34
9.1.
Statistical Hypotheses.................................................................................................34
9.2.
Sample Size Determination.........................................................................................34
9.3.
Populations for Analyses ............................................................................................34
9.4.
Statistical Analyses.....................................................................................................34
9.4.1.
Primary Endpoint........................................................................................................35
9.4.2.
Exploratory Analyses..................................................................................................35
9.4.3.
Subgroup Analyses.....................................................................................................36
9.5.
Interim Analyses.........................................................................................................36
10.
Supporting Documentation and Operational Considerations ................................37
10.1.
Appendix 1: Regulatory, Ethical, and Study Oversight 
Considerations............................................................................................................37
10.1.1.
Regulatory and Ethical Considerations........................................................................37
10.1.2.
Financial Disclosure ...................................................................................................37
10.1.3.
Informed Consent Process ..........................................................................................37
10.1.4.
Data Protection...........................................................................................................38
10.1.5.
Dissemination of Clinical Study Data .........................................................................39
10.1.6.
Data Quality Assurance ..............................................................................................39
10.1.7.
Source Documents......................................................................................................40
10.1.8.
Study and Site Start and Closure.................................................................................41
10.1.9.
Publication Policy.......................................................................................................41
10.1.10. Investigator Information .............................................................................................41
10.1.11. Long-Term Sample Retention.....................................................................................41
10.2.
Appendix 2: Adverse Events: Definitions and Procedures for 
Recording, Evaluating, Follow-Up, and Reporting......................................................42
10.2.1.
Definition of AE.........................................................................................................42
10.2.2.
Definition of SAE.......................................................................................................43
10.2.3.
Recording and Follow-Up of AE and/or SAE .............................................................44
10.2.4.
Reporting of SAEs......................................................................................................46
10.2.5.
Medication Error ........................................................................................................46


CONFIDENTIAL
Protocol J2X-MC-PYAJ
5
10.3.
Appendix 3: Contraceptive Guidance and Collection of 
Pregnancy Information ...............................................................................................47
10.4.
Appendix 4: Abbreviations .........................................................................................51
11.
References.................................................................................................................54


CONFIDENTIAL
Protocol J2X-MC-PYAJ
6
1.
Protocol Summary
1.1.
Synopsis
Protocol Title: A prospective cohort study to evaluate the real-world effectiveness of 
bamlanivimab in participants with mild-to-moderate COVID-19 at high risk for progressing to 
severe illness, with matched controls
Rationale:
This study aims to characterize the real-world effectiveness of bamlanivimab in participants with 
mild-to-moderate COVID-19 in adults and adolescents (age ≥12) who are at high risk of 
progressing to severe COVID-19 and/or hospitalization compared to a similar control population.
Objectives and Endpoints: 
Objectives
Endpoints
Primary

To determine the proportion of patients with 
COVID-related hospitalization or death by 29 days 
among bamlanivimab-treated participants 
compared to external controls.

Proportion (percentage) of participants who 
experience COVID-19 related hospitalization 
(defined as ≥24 hours of acute care) or death by
Day 29
Secondary

To determine the proportion of patients with 
COVID-related hospitalization up to 60 and 90 
days among bamlanivimab-treated participants 
compared to external controls.

COVID-19-related hospitalization, defined as ≥24 
hours of acute care, up to Days 60 and 90

To determine the proportion of patients with a 
COVID-related ED visit through Days 29, 60, and 
90.

ED visits for COVID-related causes

To describe the safety of bamlanivimab-treated 
participants through Days 29, 60, and 90.

Adverse events or serious adverse events
Abbreviation: ED = emergency department.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
7
Overall Design:
An open-label, single-arm, prospective, cohort study using matched real-world external controls. 
There is no placebo arm. 
Design Outline
Screening
Interested participants or their legally authorized representative will sign the appropriate 
informed consent and child/adolescent assent document(s), as appropriate, prior to completion of 
any procedures.
The investigator will confirm a positive RT-PCR test or antigen testing confirmation for 
COVID-19 (if antigen test is accompanied by symptoms suggestive of SARS-CoV-2 infection),
and review criteria for high risk under the EUA to confirm eligibility. 
Treatment and Assessment Period
This is the general sequence of events during the treatment and assessment period:

complete baseline procedures to confirm eligibility per inclusion and exclusion criteria 
and high-risk criteria per EUA

participants receive infusion of bamlanivimab, and

complete all safety monitoring and post-infusion data collection.
This table describes the visit types
Study Day
Visit Type
1 
Bamlanivimab infusion at site 
24 hours (+1 day)
Telephone contact 
29(±5 days), 60 (±7 days), 90 (±7 days)
EMR review and/or phone call 
Early discontinuation and follow-up
Telephone contact
If a participant is hospitalized, procedures and assessments will continue per the SoA. 
This table describes discharge from hospital scenarios if an outpatient is subsequently 
hospitalized.
Discharge from Hospital (Outpatients Subsequently Hospitalized)
If hospital discharge…
Then…
Occurs prior to Day 29
Participants will be asked to complete the remaining 
study assessments at the timepoints indicated in the 
SoA.
Occurs on the same day as a study assessment visit
Assessments do not need to be repeated if the study 
assessments occurred within 8 hours of discharge and 
there has been no change in clinical status and the 
information is available to the site.
Does not occur at or prior to Day 28
Assessments will continue to occur up to Day 90 or 
until hospital discharge, whichever is later.
Post-treatment Follow-Up


CONFIDENTIAL
Protocol J2X-MC-PYAJ
8
Post-infusion follow-up assessments will be conducted at Days 2, 28, 60, and 90 to assess 
clinical status and for adverse events.
Disclosure Statement: This is a treatment study. 
Number of Participants:
The initial plan is to enroll up to 3000 participants in the treated cohort over 4-6 weeks of 
enrollment, with the same number in the control cohort. 
Data Monitoring Committee: No


CONFIDENTIAL
Protocol J2X-MC-PYAJ
9
1.2.
Schema
The following figure illustrates the study design for participants receiving bamlanivimab.
a
Screening and Day 1 procedures may occur on the same day.
b
Telephone call 24 hours post-infusion.
c
EMR review and/or phone call.
Note: Matched controls will include NM Health Members who have EMR and claims data to determine positive 
COVID test and any subsequent healthcare utilization, including hospitalization and death data, to determine 
meeting of entry criteria such as mild/moderate symptoms.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
10
1.3.
Schedule of Activities (SoA)
Visits may be conducted as a telephone call or EMR review, as long as the protocol SoA is followed. Refer to the study day and visit 
type table in Section 4.1 for additional clarification.
This SoA is for participants receiving bamlanivimab only.
Study 
J2X-MC-PYAJ
Screen
Infusion Day
Study Day
1
2
29
60
90
ED
Screening and Day 1 procedures may occur on the same day.
Day 2 = telephone call 24 hours post-infusion
Day 29, 60, 90 = EMR and/or telephone call review as necessary
Visit Window
(± number of days)
--
2*
5
7
7
Visits may not be combined.
*Day 2 call visit window +2 only
Procedures
Informed consent
X
Inclusion and 
exclusion criteria 
review
X
Demographics
X
Including age, gender, race, ethnicity 
Preexisting 
conditions and 
medical history
X
Obtained from interview or available information.
Includes timing of exposure and onset of symptoms suggestive of 
SARS-CoV-2 infection, and risk factors and comorbidities associated 
with severe COVID-19 illness. 
Height
X
Weight
X
Prior treatments 
of special interest 
within the last 30 
days
X
NSAIDs, antivirals, antibiotics, anti-malarials, corticosteroids, 
immunomodulators, or other investigational treatments.
Tobacco use
X
Concomitant 
medications
X
X
X
X
X


CONFIDENTIAL
Protocol J2X-MC-PYAJ
11
Study 
J2X-MC-PYAJ
Screen
Infusion Day
Study Day
1
2
29
60
90
ED
Screening and Day 1 procedures may occur on the same day.
Day 2 = telephone call 24 hours post-infusion
Day 29, 60, 90 = EMR and/or telephone call review as necessary
Visit Window
(± number of days)
--
2*
5
7
7
Visits may not be combined.
*Day 2 call visit window +2 only
SAEs/AEs
X
X
X
X
X
X
X
Any events that occur after signing the informed consent are considered 
SAEs/AEs as defined in Section 10.2.
Hospitalization, ED visits, and deaths from COVID-19 are captured as 
endpoints and not as SAEs.
SAEs/AEs will also be collected at the time of early discontinuation, if 
applicable.
Physical 
examination
X
Vital signs
X
Includes: body temperature, pulse rate, BP, respiratory rate, SpO2, and 
supplemental oxygen flow rate, FiO2 if known, and method of delivery, 
if applicable.
Record SpO2 while participant is at rest.
Day 1 recommended timing of vitals: 
1.
immediately before the infusion 
2.
every 15 minutes during the infusion, as possible, and
3.
every 30 minutes for at least 1 hour after the infusion.
During infusion, record pulse rate, BP and SpO2. Automation may be 
used. See Section 8.2.2 for data collected on CRF.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
12
Study 
J2X-MC-PYAJ
Screen
Infusion Day
Study Day
1
2
29
60
90
ED
Screening and Day 1 procedures may occur on the same day.
Day 2 = telephone call 24 hours post-infusion
Day 29, 60, 90 = EMR and/or telephone call review as necessary
Visit Window
(± number of days)
--
2*
5
7
7
Visits may not be combined.
*Day 2 call visit window +2 only
Hospitalization 
events
X*
X
X
X
X
X
*Post-infusion only (otherwise exclusion criterion)
Record if the following events occur or occurred since prior 
visit:

Emergency room visits

hospitalized

ICU admittance, 

Extended care facility admittance, and

Discharge
Death
X
X
X
X
X
X
From COVID-19-related causes
Abbreviations: AE = adverse event; BP = blood pressure; CRF = case report form; ED = early discontinuation; FiO2 = fraction of inspired oxygen in the air; ICU 
= intensive care unit; NSAIDS = non-steroidal anti-inflammatory drugs; SpO2 = saturation of peripheral oxygen.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
13
2.
Introduction
2.1.
Study Rationale
The efficient community spread of SARS-CoV-2 has resulted in the current pandemic of 
COVID-19, which in severe and critical cases results in progressive pulmonary infection, 
complicated by respiratory failure, with a high prevalence of acute respiratory distress syndrome. 
Although several therapies have been explored in severe COVID-19, none have improved 
survival, including antivirals, glucocorticoids, and immunoglobulins (Liu et al 2020). 
This study aims to characterize the real-world effectiveness of bamlanivimab in participants with 
mild-to-moderate COVID-19 in adults adolescents (age ≥12) who are at high risk of progressing 
to severe COVID-19 and/or hospitalization compared to a similar control population.
2.2.
Background
The SARS-CoV-2 gains entry to cells through binding of the spike (S) protein to ACE2 receptors 
on cells (Hoffmann 2020). Eli Lilly and Company has a partnership with AbCellera Biologics 
Inc. (AbCellera; Vancouver, Canada) to develop neutralizing IgG1 mAbs to the spike (S) protein 
of SARS-CoV-2 as a potential treatment for COVID-19. Candidate antibody gene sequences 
have been selected from a recently recovered COVID-19 US patient’s serum using AbCellera’s 
core platform screening technologies.
2.3.
Benefit/Risk Assessment
Anticipated risk is considered low and is based on the known mechanism of action for human-
derived neutralizing antibodies in acute viral disease states. A theoretical risk is that this 
intervention may cause ADE of viral replication. This is based on responses observed to some 
monoclonal antibody therapies used in other unrelated viral diseases. Unlike ADE associated 
with dengue and Zika virus infections, this phenomenon has not been clearly established for 
coronavirus infections, such as SARS and Middle East respiratory syndrome, and has not been 
reported to date with SARS-CoV-2. Additionally, limited experience with the use of 
convalescent serum as a treatment for patients with severe COVID-19 disease has not indicated 
safety concerns (Shen et al. 2020; Duan et al. 2020). 
The risk of clinical ADE for either intervention or in combination is considered low due to 

the absence of ADE from in vitro studies, and

the absence of ADE from in vivo nonhuman primate studies for bamlanivimab.
To date, there is no evidence of productive enhancement of ADE with SARS-CoV-2. 
Additional manageable risks associated with most therapeutic monoclonal antibodies are the 
potential for infusion-related hypersensitivity and cytokine release reactions. The single infusion 
in this study will be administered at a controlled rate, the study participants will be monitored 
closely, and adjustments in the infusion rate will be made and/or the infusion stopped, if 
indicated. Additional information regarding infusion reaction management options is located in
Section 6.1.1.2.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
14
Given the totality of data on bamlanivimab, the well-established safety profile of other 
therapeutic mAbs, and the lack of disease-directed therapeutic options for patients with COVID-
19 illness or to prevent the SARS-CoV-2 infection, the overall benefit or risk assessment of this 
study is considered favorable.
More detailed information about the known and expected benefits and risks and reasonably 
expected adverse events of bamlanivimab may be found in the IB.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
15
3.
Objectives and Endpoints
Objectives
Endpoints
Primary

To determine the proportion of patients with 
COVID-related hospitalization or death by 29 days 
among bamlanivimab-treated participants 
compared to external controls.

Proportion (percentage) of participants who 
experience COVID-19 related hospitalization
(defined as ≥24 hours of acute care) or death by
Day 29
Secondary

To determine the proportion of patients with 
COVID-related hospitalization up to 60 and 90 
days among bamlanivimab-treated participants 
compared to external controls.

COVID-19-related hospitalization, defined as ≥24 
hours of acute care, up to Days 60 and 90

To determine the proportion of patients with a 
COVID-related ED visit through Days 29, 60, and 
90.

ED visits for COVID-related causes

To describe the safety of bamlanivimab-treated 
participants through Days 29, 60, and 90.

Adverse events or serious adverse events
Abbreviation: ED = emergency department.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
16
4.
Study Design
4.1.
Overall Design
This study is being conducted in the same population as in the Emergency Use Authorization 
(EUA [FDA 2020a]). 
Study J2X-MC-PYAJ is an open-label, single-arm, prospective, cohort study using matched real-
world external controls. There is no placebo arm.
Screening
Interested participants or their legally authorized representative will sign the appropriate 
informed consent and child or adolescent assent document(s), as appropriate, prior to completion 
of any procedures. The participant may enter the study with a previous positive SARS-CoV-2 
viral test result from an external testing facility. This test result must be the first time the 
participant has had a positive RT-PCR or antigen testing confirmation for COVID-19 (if antigen 
test is accompanied by symptoms suggestive of SARS-CoV-2 infection)for SARS-CoV-2. 
Prescreening prior to administration of bamlanivimab may be conducted to collect baseline 
information.
The investigator will review symptoms, risk factors, and other non-invasive inclusion and 
exclusion criteria prior to any invasive procedures. If the participant is eligible after this review, 
then the site will perform the invasive procedures.
Treatment and Assessment Period
This is the general sequence of events during the treatment and assessment period:

complete baseline procedures to confirm eligibility (positive COVID-19 test, high-risk 
criteria per EUA)

participants receive study intervention, and

complete all safety monitoring and post-infusion data collection. 
Treated population visit types
This table describes the visit types for the treatment population for this study.
Study day
Activity
Visit type
Up to 10 
days before 
infusion
Positive COVID-19 test
Confirm high-risk criteria per EUA
Ambulatory setting
1
Infusion
Ambulatory setting
2
AE or SAE data collection (24 hours 
post-infusion) 
Endpoints including hospitalization 
or ED visit for COVID-19
Telephone call 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
17
29
AE or SAE data collection
Primary endpoint collection—
hospitalization for COVID-19; 
EMR and/or telephone call
60, 90
AE or SAE data collection
Endpoints including hospitalization 
or ED visit for COVID-19
Electronic and/or telephone call
Abbreviations: AE = adverse event; ED = emergency department; EUA = emergency use authorization; SAE = 
serious adverse event.
Guidelines if a participant is hospitalized
If a participant is hospitalized, procedures and assessments will continue per the SoA (Section 
1.3). 
This table describes discharge from hospital scenarios if an outpatient is subsequently 
hospitalized.
If hospital discharge…
Then…
Occurs prior to Day 29
Participants will be asked to complete the remaining 
study assessments at the timepoints indicated in the 
SoA.
Occurs on the same day as a study assessment visit
Assessments do not need to be repeated if the study 
assessments occurred within 8 hours of discharge, and 
there has been no change in clinical status and the 
information is available to the site.
Does not occur at or prior to Day 29
Assessments will continue to occur up to Day 90 or 
until hospital discharge, whichever is later.
Abbreviation: SoA = schedule of activities.
Post-treatment follow-up
Post-treatment follow-up assessments will be conducted at Days 2, 29, 60, and 90 to assess study 
endpoints.
4.2.
Scientific Rationale for Study Design
Overall Design
This study is designed to characterize the real-world effectiveness of bamlanivimab in 
participants with mild-to-moderate COVID-19 in adults and children who are at high risk of 
progressing to severe COVID-19 and/or hospitalization compared to a similar control population.
Participant Characteristics
The participant population are those infected with SARS-CoV-2 who are at high risk of 
developing severe disease requiring hospitalization. There is historical evidence that patients 
infected with upper respiratory viruses who are treated early in their disease course have better 
responses to anti-viral therapies (Aoki et al., 2003); all patients in the treated cohort will receive 
an infusion of bamlanivimab within 10 days of their positive COVID-19 test.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
18
The population of participants with mild-to-moderate COVID-19 illness who are at high risk of 
developing severe disease per the EUA was chosen to evaluate if effective antiviral antibody 
therapy may prevent progression to the severe form of COVID-19 illness by treating this 
population early in their disease course and prior to respiratory compromise and failure. 
Participants with these risk factors are at higher risk for more severe disease and hospitalization. 
This population was chosen to evaluate if effective antiviral antibody therapy may prevent 
hospitalization or death. 
4.3.
Justification for Dose
Bamlanivimab-700 mg was estimated as the maximum therapeutic dose based on PK/PD viral 
dynamics modeling of Study J2W-MC-PYAB and has a sustained concentration above the in 
vitro IC90 of viral cell-entry neutralization in the lung tissue (95th percentile of the estimates 
used) for at least 28 days in 90% of the participant population.
4.4.
End of Study Definition
A participant is considered to have completed the study if they have completed all required 
phases of the study including the last scheduled procedure shown in the SoA (Section 1.3).
The end of the study is defined as the date of last scheduled procedure shown in the SoA
(Section 1.3) for the last participant in the trial.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
19
5.
Study Population
Prospective approval of protocol deviations to recruitment and enrollment criteria, also known as 
protocol waivers or exemptions, is not permitted.
Due to the criticality of participant health, verbal interview of the potential participant, or their
legal representative or family member, may be the source for disease characteristics and medical 
history, unless otherwise specified within the eligibility criteria.
5.1.
Inclusion Criteria
Participants are eligible to be included in the study only if all of the following criteria apply:
Age
1. Are ≥12 years of age at the time of screening
Disease Characteristics
2. Are currently not hospitalized
3. Have one or more mild or moderate COVID-19 symptoms (FDA resource page, available
at: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/covid-
19-developing-drugs-and-biological-products-treatment-or-prevention) 
i. Fever
ii. Cough
iii. Sore throat
iv. Malaise
v. Headache
vi. Muscle pain 
vii. Gastrointestinal symptoms, or
viii. Shortness of breath with exertion
4. Must have first positive SARS-CoV-2 viral infection determination and as soon as 
possible within 10 days of symptom onset
5. Are males or non-breastfeeding females
Reproductive and Contraceptive agreements and guidance is provided in Section 10.3,
Appendix 3. Contraceptive use by males or females should be consistent with local 
regulations for those participating in clinical studies
Study Procedures
6. Understand and agree to comply with planned study procedures


CONFIDENTIAL
Protocol J2X-MC-PYAJ
20
Informed Consent
7. The participant or legally authorized representative gives signed informed consent and/or 
assent as described in Section 10.1.3, which includes compliance with the requirements 
and restrictions listed in the ICF and in this protocol
High risk as defined per EUA fact sheet: https://www.fda.gov/media/143603/download
8. For example, participants who meet at least 1 of the following criteria:

Have a BMI ≥35

Have chronic kidney disease

Have diabetes

Have immunosuppressive disease

Are currently receiving immunosuppressive treatment

Are ≥65 years of age

Are ≥55 years of age AND have
•
cardiovascular disease, OR
•
hypertension, OR
•
chronic obstructive pulmonary disease or other chronic respiratory 
disease.

Are 12–17 years of age AND have
•
BMI ≥85th percentile for their age and gender based on CDC 
growth charts, 
https://www.cdc.gov/growthcharts/clinical_charts.htm, OR
•
sickle cell disease, OR
•
congenital or acquired heart disease, OR
•
neurodevelopmental disorders, for example, cerebral palsy, OR
•
a medical-related technological dependence, for example, 
tracheostomy, gastrostomy, or positive pressure ventilation (not 
related to COVID-19), OR
•
asthma, reactive airway or other chronic respiratory disease that 
requires daily medication for control.
5.2.
Exclusion Criteria 
Limitations of Benefit and Potential for Risk in Patients with Severe COVID-19
Benefit of treatment with bamlanivimab has not been observed in patients hospitalized due to 
COVID-19. Monoclonal antibodies, such as bamlanivimab, may be associated with worse 
clinical outcomes when administered to hospitalized patients with COVID-19 requiring high 
flow oxygen or mechanical ventilation.
More specifically, participants are excluded from the study if any of the following criteria apply:
Medical Conditions
9. Participants who:
a.
are hospitalized due to COVID-19, OR 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
21
b. require oxygen therapy due to COVID-19, OR 
c.
require an increase in baseline oxygen flow rate due to COVID-19 in those on 
chronic oxygen therapy due to underlying non-COVID-19 related comorbidity.
10. Have SpO2 ≤ 90% on room air or PaO2/FiO2 < 300, respiratory rate ≥30 per minute, 
heart rate ≥125 per minute (FDA resource page, available at: 
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/covid-19-
developing-drugs-and-biological-products-treatment-or-prevention) 
11. Have body weight <40 kg.
12. Require mechanical ventilation or anticipated impending need for mechanical ventilation 
13. Have known allergies to any of the components used in the formulation of the 
interventions
14. Suspected or proven serious, active bacterial, fungal, viral, or other infection (besides 
COVID-19) that in the opinion of the investigator could constitute a risk when taking 
intervention
15. Have any comorbidity requiring surgery within <7 days, or that is considered life-
threatening within 29 days
16. Have any serious concomitant systemic disease, condition, or disorder that, in the opinion 
of the investigator, should preclude participation in this study
Other Exclusions
17. Have a history of a positive SARS-CoV-2 serology test
18. Have a history of a positive SARS-CoV-2 test prior to the one serving as eligibility for 
this study
19. Have received an investigational intervention for SARS-CoV-2 prophylaxis within 30 
days before dosing
20. Have received treatment with a SARS-CoV-2-specific monoclonal antibody, remdesivir, 
or other treatment for COVID-19
21. Have received convalescent COVID-19 plasma treatment 
22. Have participated in a previous SARS-CoV-2 vaccine study
23. Have participated, within the last 30 days, in a clinical study involving an investigational 
intervention. If the previous investigational intervention has a long half-life, 5 half-lives 
or 30 days, whichever is longer, should have passed.
24. Are concurrently enrolled in any other type of medical research judged not to be
scientifically or medically compatible with this study
25. Are breast-feeding
26. Are investigator site personnel directly affiliated with this study, and
5.3.
Matched controls
Matched controls will include NM Health System members who have EMR and claims data to 
determine positive COVID test and any subsequent healthcare utilization, including 
hospitalization and death data. Data for control participants will indicate that that they are similar 
to treated participants according to COVID-19 symptoms and other study entry criteria. If 
applicable, non-NM Health System members may be used as members of the control 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
22
population based on EMR review and matching to enrolled participants. A waiver of informed 
consent and HIPAA authorization will be requested for matched controls.
5.4.
Lifestyle Considerations
Reproductive and Contraceptive guidance is provided in Section 10.3, Appendix 3.
5.5.
Screen Failures
Screen failures are defined as participants who consent to participate in the clinical study but are 
not subsequently enrolled in the study. A minimal set of screen failure information is required to 
ensure transparent reporting of screen failure participants to meet the Consolidated Standards of 
Reporting Trials publishing requirements and to respond to queries from regulatory authorities. 
Minimal information includes demography, screen failure details, eligibility criteria, and any 
SAE.
Individuals who do not meet the criteria for participation in this study (screen failure) may not be 
rescreened.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
23
6.
Study Intervention
Study intervention is defined as any investigational intervention(s), marketed product(s), 
placebo, or medical device(s) intended to be administered to/used by a study participant 
according to the study protocol.
6.1.
Study Intervention(s) Administered
Each participant will receive a single IV infusion of bamlanivimab.
Study intervention must be administered within 10 days of symptom onset and following the first 
positive SARS-CoV-2 test sample collection.
Intervention name
Bamlanivimab (LY3819253)
Dose formulation
Solution
Dosage level (mg)
700
Use
Experimental
IMP and NIMP
IMP
Sourcing
From Lilly
Packaging and labeling
Study intervention will be 
provided in glass vials and 
will be labeled appropriately
Abbreviations: IMP = investigational medicinal product; IV = intravenous; NIMP = non-investigational medicinal 
product.
Infusion information may be found in the pharmacy manual.
The infusion rate may be reduced as deemed necessary if an infusion reaction is observed 
(Section 6.1.1.2). Participants will be monitored for at least 1 hour after completion of the 
infusion. 
The site must have age-appropriate resuscitation equipment, emergency drugs, and appropriately 
training staff available during the infusion and for at least 1 hour after the completion of the 
infusion.
Self-isolation procedures should be followed per local guidelines.
6.1.1.
Special Treatment Considerations
6.1.1.1.
Premedication for Infusions
Premedication for infusions is not planned. However, if an infusion reaction occurs during 
administration or if the participant has a medical history suggesting a potential benefit from 
premedication, the study investigator(s) should determine the appropriate premedication. The 
investigators and sponsor may decide to use premedication if the frequency of infusion reactions 
among participants warrants it.
If minor infusion reactions are observed, administration of acetaminophen, 500 to 1000 mg, 
antihistamines, and/or other appropriately indicated medications may be given prior to the start 
of infusions for subsequent participants. 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
24
The decision to implement premedication for infusions in subsequent participants will be made 
by the investigator and sponsor and recorded in the study documentation.
Any premedications given will be documented as a concomitant therapy.
6.1.1.2.
Management of Infusion Reactions
Access to medications (e.g., epinephrine, norepinephrine, steroids, and diphenhydramine) for 
potential anaphylaxis and serious infusion reactions is mandatory at all infusion sites.
Symptoms and Signs
Symptoms and signs that may occur as part of an infusion reaction include, but are not limited to,
fever, chills, nausea, headache, bronchospasm, hypotension, angioedema, throat irritation, rash
including urticaria, pruritus, myalgia, and dizziness.
Infusion-related reaction severity will be assessed and reported using the DAIDS Table for 
Grading the Severity of Adult and Pediatric Adverse Events, version 2.1 (July 2017). 
This table describes the severity of reactions according to DAIDS. 
Parameter
Mild
Moderate
Severe
Severe and 
Potentially Life-
threatening
Acute 
Allergic 
Reaction
Localized urticaria
(wheals) with no medical 
intervention indicated
Localized urticaria 
with intervention 
indicated 
OR 
Mild angioedema 
with no intervention 
indicated
Generalized 
urticaria
OR
Angioedema with 
intervention 
indicated 
OR
Symptoms of mild 
bronchospasm
Acute anaphylaxis 
OR 
Life-threatening 
bronchospasm 
OR
Laryngeal edema
Source: DAIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 2.1 (July 2017).
6.1.2.
Temporary Stopping Criteria
A study sponsor representative and/or study medical monitor will review evolving unblinded 
safety data to determine if any changes should be made to study conduct.
This table describes the location of AE-related information in this protocol.
Topic
Location
DAIDS table describing severity of reactions
Section 6.1.1.2
Definition of AEs 
Section 10.2.1
Assessment of intensity or severity
Section 10.2.3
Abbreviations: AE = adverse event; DAIDS = Division of AIDS.
Changes to the planned dosing schedule must be appropriately documented and communicated 
with the study personnel and the IRB/IEC before dosing continues.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
25
6.2.
Preparation/Handling/Storage/Accountability
The investigator or designee must confirm appropriate storage conditions have been maintained 
during transit for all study intervention received and any discrepancies are reported and resolved 
before use of the study intervention.
Only participants enrolled in the study may receive study intervention, and only authorized site 
staff may supply or administer study intervention. 
All study intervention must be stored in a secure, environmentally controlled, and monitored 
(manual or automated) area in accordance with the labeled storage conditions with access limited 
to the investigator and authorized study personnel.
The investigator or designee is responsible for study intervention accountability, reconciliation, 
and record maintenance (i.e., receipt, reconciliation, and final disposition records).
Further guidance and information for the final disposition of unused study interventions are 
provided in the pharmacy manual.
6.3.
Measures to Minimize Bias: Randomization and Blinding
Propensity Score Matching
The non-randomized nature of a cohort study introduces the possibility of bias. Therefore, the 
analysis will use propensity score (PS) matching using risk factors associated with 
hospitalization for COVID-19. The purpose of PS matching is to create balance in the 2 cohorts 
on specific relevant covariates. PS will be estimated for each patient in the bamlanivimab group 
and the comparator cohort by the logistic regression model, with treatment status as the 
dependent variable and the pre-defined independent variables considered as the potential 
confounders. The success of the PS is judged by the balance in the confounder distributions it 
produces between the 2 study groups. Prior to initiating the outcome analysis, the quality of the 
PS adjustment and associated assumptions will be evaluated. The PS model will be finalized 
prior to initiating the analysis of the outcome measure. Further details will be provided in the 
SAP.
6.4.
Study Intervention Compliance
Participants will receive study intervention directly from the investigator or designee, under 
medical supervision. The date and time of dosing will be recorded in the source documents and 
recorded in the CRF. The dose of study intervention and study participant identification will be 
confirmed at the time of dosing by a member of the study site staff other than the person 
administering the study intervention.
6.5.
Concomitant Therapy
Prior Treatment
Convalescent COVID-19 plasma treatment is not allowed prior to enrollment.
For adolescent participants, record any vaccines received 90 days prior to signing informed 
consent.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
26
Concomitant Therapy
Participants should be treated according to standard of care, even as it evolves, and medications 
may be part of the treatment paradigm. Therefore, remdesivir, or baricitinib plus remdesivir, may 
be initiated as standard of care for participants hospitalized with severe disease (if available 
through the FDA EUAs) if hospitalization occurs following infusion of bamlanivimab. 
If the local standard of care per written policies or guidelines (i.e., not just an individual clinician 
decision) includes lopinavir or ritonavir, chloroquine, hydroxychloroquine, or other 
investigational agents, then initiating these during the study (after infusion of bamlanivimab) is 
permitted but may require additional safety monitoring by the site.
Any medication, investigational agent, or vaccine, including over-the-counter or prescription 
medicines, vitamins, and/or herbal supplements, or other specific categories of interest that the 
participant is receiving at the time of enrollment or receives during the study must be recorded 
along with

reason for use

dates of administration including start and end dates, and

dosage information including dose and frequency for concomitant therapy of special 
interest.
Acetaminophen and corticosteroid use are permitted at any time during the study.
Other concomitant medication may be considered on a case-by-case basis by the investigator in 
consultation with the sponsor if required.
The sponsor should be contacted if there are any questions regarding concomitant or prior 
therapy.
6.6.
Dose Modifications
No dose modifications are planned for this study.
6.7.
Intervention after the End of the Study
No continued access is planned after completion of this study. 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
27
7.
Discontinuation of Study Intervention and Participant 
Discontinuation/Withdrawal
Discontinuation of specific sites or that of the trial as a whole are handled as part of regulatory, 
ethical, and trial oversight considerations in Section 10.1, Appendix 1.
7.1.
Discontinuation of Study Intervention
In rare instances, it may be necessary for a participant to permanently discontinue study 
intervention. If the IV infusion is definitively discontinued, the participant will remain in the 
study for the remainder of the assessment visits through Day 90.
7.2.
Participant Discontinuation/Withdrawal from the Study
A participant may withdraw from the study 

at any time at his or her own request

at the request of his or her designee (e.g., parents or legal guardian)

at the discretion of the investigator for safety, behavioral, compliance, or administrative 
reasons, and

if enrollment in any other clinical study involving an investigational product or 
enrollment in any other type of medical research judged not to be scientifically or 
medically compatible with this study.
Discontinuation is expected to be uncommon.
At the time of discontinuation, if possible, an early discontinuation phone call should be 
conducted to ascertain SAEs/AEs, as described in the SoA (Section 1.3).
If the participant withdraws consent for disclosure of future information, the sponsor may retain 
and continue to use any data collected before such a withdrawal of consent. If a participant 
withdraws from the study, they may request destruction of any samples taken and not tested, and 
the investigator must document this in the site study records.
7.2.1.
Discontinuation of Inadvertently Enrolled Participants
If the sponsor or investigator identifies a participant who did not meet enrollment criteria and 
was inadvertently enrolled, then the participant should be discontinued from study intervention
unless there are extenuating circumstances that make it medically necessary for the participant to 
continue study intervention.
If the investigator and the sponsor CRP agree it is medically appropriate to continue, the 
investigator must obtain documented approval from the sponsor CRP to allow the inadvertently 
enrolled participant to continue in the study with or without treatment with investigational 
product.
Safety follow-up is as outlined in 

Section 1.3 (SoA) 

Section 8.2 (Safety Assessments), and 

Section 8.3 (Adverse Events and Serious Adverse Events).


CONFIDENTIAL
Protocol J2X-MC-PYAJ
28
7.3.
Lost to Follow-Up
A participant will be considered lost to follow-up if he or she repeatedly is unavailable for
scheduled visits and is unable to be contacted by the study site. Site personnel or designee are 
expected to make diligent attempts to contact participants who are unavailable for a scheduled 
visit or were otherwise unable to be followed up by the site.
Site personnel, or an independent third party, will attempt to collect the vital status of the 
participant within legal and ethical boundaries for all participants that received study 
intervention. Public sources may be searched for vital status information. If vital status is 
determined to be deceased, this will be documented and the participant will not be considered 
lost to follow-up. Sponsor personnel will not be involved in any attempts to collect vital status 
information.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
29
8.
Study Assessments and Procedures
Study procedures and their timing are summarized in the SoA (Section 1.3).
Protocol waivers or exemptions are not allowed.
After signing of informed consent, any immediate safety concerns should be discussed with the 
sponsor immediately upon occurrence or awareness to determine if the participant should 
continue or discontinue study intervention. All outlined AE or SAE reporting must be done as 
applicable.
Adherence to the study design requirements, including those specified in the SoA (Section 1.3), 
is essential and required for study conduct.
All screening evaluations must be completed and reviewed to confirm that potential participants 
meet all eligibility criteria. The investigator will maintain a screening log to record details of all 
participants screened and to confirm eligibility or record reasons for screening failure, as 
applicable.
Data for this study will be collected from telephone calls and the EMR. 
8.1.
Efficacy Assessments
Hospitalization events (Section 8.2.2) will be used to characterize the primary outcome. 
8.2.
Safety Assessments
Planned time points for all safety assessments are provided in the SoA (Section 1.3).
8.2.1.
Vital Signs
Vital signs will be measured as specified in the SoA (Section 1.3) at the infusion visit. Vital 
signs include

body temperature

blood pressure

pulse rate

respiration rate

saturation of peripheral oxygen, and

supplemental oxygen flow rate, FiO2 if known, and method of delivery, if applicable.
Additional vital signs may be measured during the study if warranted, as determined by the 
investigator.
8.2.2.
Hospitalization Events
If a participant is admitted to the hospital, the participant will remain in the study and follow the 
procedures outlined in the SoA (Section 1.3). Hospitalization is defined as ≥24 hours of acute 
care.
The date of hospitalization events will be recorded in the CRF and includes

hospitalization 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
30

emergency room visit 

ICU admittance

extended care facility admittance, and 

discharge.
8.3.
Adverse Events and Serious Adverse Events
AEs will be reported by the participant, or, when appropriate, by a caregiver, surrogate, or the 
participant’s legally authorized representative. Hospitalization, ED, visits, and deaths from 
COVID-19 are captured as endpoints and not as AEs or SAEs (see Section 10.2.1).
The investigator and any qualified designees are responsible for detecting, documenting, and 
recording events that meet the definition of an AE or SAE and remain responsible for following 
up AEs that are serious, considered related to the study intervention or study procedures, or that 
caused the participant to discontinue the study intervention or study.
8.3.1.
Time Period and Frequency for Collecting AE and SAE Information
All AEs and SAEs will be collected from the time of signing of the ICF until participation in 
study has ended.
Adverse events that begin before the start of study intervention but after signing of the ICF will 
be recorded on the Adverse Event CRF.
Although all AEs after signing the ICF are recorded by the site in the CRF/electronic data entry, 
SAE reporting to sponsor begins after the participant has signed the ICF and has received study 
intervention. However, if an SAE occurs after signing the ICF, but prior to receiving study 
intervention, it needs to be reported within the SAE reporting timeframe if it is considered 
reasonably possibly related to study procedures.
All SAEs will be recorded and reported to the sponsor or designee immediately and under no 
circumstance should this exceed 24 hours of awareness, as indicated in Section 10.2, Appendix 
2. The investigator will submit any updated SAE data to the sponsor within 24 hours of it being 
available.
Investigators are not obligated to actively seek AEs or SAEs after conclusion of the study 
participation. However, if the investigator learns of any SAE, including a death, at any time after 
a participant has been discharged from the study, and he or she considers the event to be 
reasonably related to the study intervention or study participation, the investigator must promptly 
notify the sponsor.
8.3.2.
Method of Detecting AEs and SAEs
The method of recording, evaluating, and assessing causality of AE and SAE and the procedures 
for completing and transmitting SAE reports are provided in Section 10.2.
Care will be taken not to introduce bias when detecting AEs and/or SAEs. Open-ended and non-
leading verbal questioning of the participant is the preferred method to inquire about AE
occurrences.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
31
8.3.3.
Follow-Up of AEs and SAEs
After the initial AE or SAE report, the investigator is required to proactively follow each 
participant at subsequent visits or contacts. All SAEs will be followed until resolution, 
stabilization, the event is otherwise explained, or the participant is lost to follow-up (as defined 
in Section 7.3). Further information on follow-up procedures is provided in Section 10.2.
8.3.4.
Regulatory Reporting Requirements for SAEs
Prompt notification by the investigator to the sponsor of an SAE is essential so that legal 
obligations and ethical responsibilities towards the safety of participants and the safety of a study 
intervention under clinical investigation are met.
The sponsor has a legal responsibility to notify both the local regulatory authority and other 
regulatory agencies about the safety of a study intervention under clinical investigation. The 
sponsor will comply with country-specific regulatory requirements relating to safety reporting to 
the regulatory authority, IRB/IEC, and investigators.
An investigator who receives an investigator safety report describing an SAE or other specific 
safety information (e.g., summary or listing of SAEs) from the sponsor will review and then file 
it with the IB and will notify the IRB/IEC, if appropriate according to local requirements.
8.3.5.
Pregnancy
Details of all pregnancies in female participants will be collected for 90 days after pregnancy
outcome.
If a pregnancy is reported, the investigator should inform the sponsor within 24 hours of learning 
of the pregnancy and should follow the procedures outlined in Section 10.3, Appendix 3.
Abnormal pregnancy outcomes, for example, spontaneous abortion, fetal death, stillbirth, 
congenital anomalies, and ectopic pregnancy, are considered SAEs.
8.3.6.
Hypersensitivity Reactions
Many drugs, but particularly biologic agents, carry the risk of systemic hypersensitivity 
reactions.
If such a reaction occurs, additional details describing each symptom should be provided to the 
sponsor in the infusion-related reaction/hypersensitivity CRF.
Sites should have appropriately trained medical staff and appropriate medical equipment 
available when study participants are receiving intervention. It is recommended that participants
who experience a systemic hypersensitivity reaction be treated per the local standard of care.
8.3.7. Infusion-related Reactions
As with other mAbs, infusion-related reactions may occur during or following IV administration. 
If an infusion-related reaction occurs, additional data describing each symptom and sign should 
be provided to the sponsor in the CRF.
This table describes the location of infusion-related reaction information in this protocol.
Topic
Location


CONFIDENTIAL
Protocol J2X-MC-PYAJ
32
Special treatment considerations
Section 6.1.1
Premedication for infusions
Section 6.1.1.1
Management of infusion reactions
Section 6.1.1.2
DAIDS table describing severity
Section 6.1.1.2
Treatment guidelines for infusion-related reactions 
Section 6.1.1.2
Symptoms occurring during or after infusion of study intervention may also be defined according 
to AE categories such as acute allergic reaction (refer to DAIDS).
8.3.8. Product Complaints
A product complaint is any written, electronic, or oral communication that alleges deficiencies 
related to the identity, quality, durability, reliability, safety, effectiveness, or performance of a 
trial intervention. This may include reporting of any medication errors whether or not associated 
with an adverse event.
Sponsor collects product complaints on study intervention and drug delivery systems used in 
clinical studies in order to ensure the safety of study participants, monitor quality, and to 
facilitate process and product improvements.
Participants will be instructed to contact the investigator as soon as possible if they have a 
complaint or problem with the intervention so that the situation can be assessed.
NOTE: AEs/SAEs that are associated with a product complaint will also follow the processes 
outlined in Section 8.3.3 and Appendix 10.2 of the protocol.
Time Period for Detecting Product Complaints
Product complaints that result in an adverse event will be detected, documented, and reported to 
the sponsor during all periods of the study in which the intervention is used.
If the investigator learns of any product complaint at any time after a participant has been 
discharged from the study, and such incident is considered reasonably related to an intervention
provided for the study, the investigator will promptly notify the sponsor.
Prompt Reporting of Product Complaints to Sponsor
Product complaints will be reported to the sponsor within 24 hours after the investigator becomes 
aware of the complaint.
The Product Complaint Form will be sent to the sponsor by a method designated by the sponsor.
Follow-Up of Product Complaints
Follow-up applies to all participants, including those who discontinue study intervention.
The investigator is responsible for ensuring that follow-up includes any supplemental 
investigations as indicated to elucidate the nature and/or causality of the product complaint.
New or updated information will be recorded on the originally completed form with all changes 
signed and dated by the investigator and submitted to the sponsor.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
33
8.4.
Treatment of Overdose
There is no known antidote for an overdose of bamlanivimab. 
In the event of an overdose, the investigator should
1. contact the sponsor immediately
2. closely monitor the participant for any AE or SAE and laboratory abnormalities 
3. provide supportive care as necessary, and
4. document the quantity of the excess dose in the CRF.
Decisions regarding infusion interruptions or modifications will be made by the investigator, in 
consultation with the sponsor, based on the clinical evaluation of the participant.
8.5.
Pharmacokinetics
This section is not applicable for this study.
8.6.
Pharmacodynamics
This section is not applicable for this study.
8.7.
Genetics
This section is not applicable for this study.
8.8.
Biomarkers
This section is not applicable for this study.
8.9.
Immunogenicity Assessments
This section is not applicable for this study.
8.10.
Health Economics
This section is not applicable for this study.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
34
9.
Statistical Considerations
9.1.
Statistical Hypotheses
The null hypothesis is that the proportions of bamlanivimab-treated and control patients with
COVID-19-related hospitalization by Day 29 will be similar.
9.2.
Sample Size Determination
Sample Size
A sample size of at least 500 treated patients (and 500 control patients) will provide 
approximately 90% power to detect a treatment difference for the primary analysis, assuming the 
true rates of hospitalization are 12% in the control group and at most 6% in the treated group 
using a 2-sided 0.05 level analysis (accounting for 5% lost to follow up). For the exploratory 
subset analyses, a comparison of the effectiveness of treatment within multiple subsets based on 
age, comorbidities and other potential factors is of interest.  A total sample size of 3000 in each 
group will provide at least 90% power under the same assumptions within each subgroup of 
interest, as long as the subset makes up at least 17% of the full population.  This also assumes no 
multiplicity adjustment in the subset analyses.
A full discussion of power calculations will be provided in the SAP.
9.3.
Populations for Analyses
This table defines the populations for analysis. 
Population
Description
Entered
All participants who sign the informed consent form.
Efficacy
All participants who received study intervention and provided at least one 
post-baseline measure for the relevant endpoint. Participants will be analyzed 
according to whether they received the study intervention (treated group,
control group).
Safety
All participants who received study intervention.
9.4.
Statistical Analyses
The primary analysis is a comparison of rates of hospitalization for COVID-19 between treated 
patients and the control group in the Efficacy population. The pool of potential control patients 
will be obtained from patients in the EMR/claims data populations who meet the study entry 
criteria and would qualify for bamlanivimab treatment (but did not receive it). PS matching using 
risk factors associated with hospitalization for COVID-19 will be used to create a control group 
from the pool of potential control patients that provide balance with the treated patients on the
relevant covariates. PS will be estimated for each patient in the bamlanivimab group and the 
comparator cohort by the logistic regression model, with treatment status as the dependent 
variable and the pre-defined independent variables considered as the potential confounders. For 
the PS matching process, each eligible patient receiving bamlanivimab will be matched to a 
control patient by a greedy 1:1 matching algorithm (D’Agostino 1998) with sampling without 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
35
replacement. The algorithm will utilize logit of PS with a caliper of 0.2 standard deviations of the 
logit of the PS (Austin 2014). 
The success of the propensity score is judged by the balance in the confounder distributions it 
produces between the 2 study groups. Prior to initiating the outcome analysis, the quality of the 
PS adjustment and associated assumptions will be evaluated. The PS model will be finalized 
prior to initiating the analysis of the outcome measure. 
The primary analysis will then be a comparison of the proportions of patients with a COVID-19-
related hospitalization by Day 29 between the 2 treatment groups using a logistic regression
model adjusting for variables a priori expected to be related to the outcome. Similarly, secondary 
analyses will include comparisons of the proportions of patients with COVID-19-related 
hospitalizations by Days 60 and 90, COVID-19-related ED visits, and COVID-19-related 
mortality through Days 29, 60, and 90 between the treatment groups, and will describe AEs and 
SAEs in bamlanivimab-treated patients. These details will be documented in the SAP prior to 
analysis.
9.4.1.
Primary Endpoint
Proportion (percentage) of participants who experience COVID-19 related hospitalization
(defined as ≥24 hours of acute care) or death by Day 29.
9.4.1.1.
Safety analysis

COVID-19 related hospitalization, defined as ≥24 hours of acute care, up to Days 60 and 
90

ED visits for COVID-related causes

AEs/SAEs
Safety analyses will be conducted using the safety population described in Section 9.3.
All investigational product and protocol procedure AEs will be listed, and if the frequency of 
events allows, safety data will be summarized using descriptive methodology.
The incidence of AEs will be presented by severity and by association with intervention as 
perceived by the investigator, regardless of ascertainment of relatedness.
Safety parameters that will be assessed include AEs and SAEs. The parameters will be listed and 
summarized using standard descriptive statistics.
9.4.2.
Exploratory Analyses
Full details of the planned exploratory analyses will be described in the SAP and may include 
changes to the adjustment method such as dual matching to include both prognostic and 
propensity matching. E-value or other unmeasured confounding sensitivity analyses may also be 
included.
Additional exploratory analyses of the data will be conducted as deemed appropriate. Study 
results may be pooled with the results of other studies for safety.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
36
9.4.3.
Subgroup Analyses
This may not be powered for subgroup analyses; therefore, all subgroup analyses will be treated 
as exploratory.
Subgroup analyses may be conducted for the primary endpoint. Subgroups may include 

age 

sex 

race

ethnicity

baseline weight

baseline body mass index

concomitant medication

various risk factors per EUA (see section 5.1)
More details on subgroup analyses will be outlined in the study SAP.
9.5.
Interim Analyses 
Not applicable


CONFIDENTIAL
Protocol J2X-MC-PYAJ
37
10.
Supporting Documentation and Operational Considerations
10.1.
Appendix 1: Regulatory, Ethical, and Study Oversight 
Considerations
10.1.1.
Regulatory and Ethical Considerations
This study will be conducted in accordance with the protocol and with the following:

consensus ethical principles derived from international guidelines including the 
Declaration of Helsinki and Council for International Organizations of Medical Sciences 
International Ethical Guidelines

applicable International Council for Harmonization (ICH) Good Clinical Practice (GCP) 
Guidelines, and

applicable laws and regulations.
The protocol, protocol amendments, ICF, IB, and other relevant documents (e.g., advertisements) 
must be submitted to an IRB/IEC by the investigator and reviewed and approved by the IRB/IEC 
before the study is initiated.
Any amendments to the protocol will require IRB/IEC approval before implementation of 
changes made to the study design, except for changes necessary to eliminate an immediate 
hazard to study participants.
The investigator will be responsible for the following:

providing written summaries of the status of the study to the IRB/IEC annually or more 
frequently in accordance with the requirements, policies, and procedures established by 
the IRB/IEC

notifying the IRB/IEC of SAEs or other significant safety findings as required by 
IRB/IEC procedures, and

providing oversight of the conduct of the study at the site and adherence to requirements 
of 21 CFR, ICH guidelines, the IRB/IEC, European regulation 536/2014 for clinical 
studies (if applicable), and all other applicable local regulations.
Investigator sites are compensated for participation in the study as detailed in the CTA.
10.1.2.
Financial Disclosure
Investigators and sub-investigators will provide the sponsor with sufficient, accurate financial 
information as requested to allow the sponsor to submit complete and accurate financial 
certification or disclosure statements to the appropriate regulatory authorities. Investigators are 
responsible for providing information on financial interests during the study and for 1 year after 
the completion of the study.
10.1.3.
Informed Consent Process
The investigator or his/her representative will explain the nature of the study, including the risks 
and benefits, to the participant or their legally authorized representative and answer all questions 
regarding the study.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
38
Participants must be informed that their participation is voluntary. Participants or their legally 
authorized representative will be required to sign a statement of informed consent and 
child/adolescent assent, as appropriate, that meets the requirements of 21 CFR 50, local 
regulations, ICH guidelines, Health Insurance Portability and Accountability Act requirements, 
where applicable, and the IRB/IEC or study center.
Due to strict respiratory isolation policies, limited access to COVID-19 patient rooms, and 
SARS-CoV-2 transmissibility via droplet-contaminated paper, verbal consent, and alternative 
methods of obtaining consent (e.g., by phone) will be allowed if approved by the IRB. 
If a signed paper copy of the ICF or child/adolescent assent is allowed by site/institution policy, 
then the process of how it will be obtained and stored will need to be determined.
Any variation from the standard consent process due to isolation and infection control should be 
sent to the IRB for approval prior to enrollment. The site will document the process in their 
regulatory files and demonstrate that the process has IRB concurrence or approval.
The medical record must include a statement that written informed consent or child/adolescent 
assent (if deemed appropriate by local ethics review) was obtained before the participant was 
entered in the study and the date the written consent or assent was obtained. The authorized 
person obtaining the informed consent or child/adolescent assent, and, if applicable, the 
individual designated to witness a verbal consent, must also sign the ICF. The medical record 
should also describe how the investigator determined that the person signing the ICF was the 
participant’s legally authorized representative (parent/guardian).
Participants and (when applicable) their legally acceptable representative, parent(s), or legal 
guardian must be re-consented to the most current version of the ICF(s) during their participation 
in the study, per the reconsenting guidelines as appropriate. Verbal reconsenting and alternative 
methods of obtaining consent may be utilized if approved by the IRB.
Minor participants must be re-consented if they reach the age of majority during the course of 
study, in order to continue participating.
A copy of the ICF(s) must be provided to the participant or the participant’s legally authorized 
representative and is kept on file.
10.1.4.
Data Protection
Participants will be assigned a unique identifier by the sponsor. Any participant records, datasets,
or tissue samples that are transferred to the sponsor will contain the identifier only; participant 
names or any information which would make the participant identifiable will not be transferred.
The participant must be informed that their personal study-related data will be used by the 
sponsor in accordance with local data protection law. The level of disclosure must also be 
explained to the participant who will be required to give consent for their data to be used as 
described in the informed consent.
The participant must be informed that their medical records may be examined by Clinical 
Quality Assurance auditors or other authorized personnel appointed by the sponsor, by 
appropriate IRB/IEC members, and by inspectors from regulatory authorities.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
39
The sponsor has processes in place to ensure data protection, information security, and data 
integrity. These processes include appropriate contingency plan(s) for appropriate and timely 
response in the event of a data security breach.
10.1.5.
Dissemination of Clinical Study Data
A clinical study report will be provided for this study and a summary of study information 
provided on publicly available websites. 
10.1.6.
Data Quality Assurance
Investigator responsibilities
All participant data relating to the study will be recorded on printed or electronic CRF unless 
transmitted to the sponsor or designee electronically (e.g., laboratory data). The investigator is 
responsible for verifying that data entries are accurate and correct by physically or electronically 
signing the CRF.
The investigator must maintain accurate documentation (source data) that supports the 
information entered in the CRF.
The investigator must permit study-related monitoring, audits, IRB/IEC review, and regulatory 
agency inspections and provide direct access to source data documents.
Data monitoring and management
The monitoring plan includes

monitoring details describing strategy, for example, risk-based initiatives in operations 
and quality, such as Risk Management and Mitigation Strategies and Analytical Risk-
Based Monitoring 

methods 

responsibilities and requirements 

handling of noncompliance issues, and 

monitoring techniques.
The sponsor or designee is responsible for the data management of this study including quality 
checking of the data. The sponsor assumes accountability for actions delegated to other 
individuals (e.g., Contract Research Organizations).
Study monitors will perform ongoing source data verification to confirm that data entered into 
the CRF by authorized site personnel are accurate, complete, and verifiable from source 
documents. They will also ensure that the safety and rights of participants are being protected 
and that the study is being conducted in accordance with the currently approved protocol and any 
other study agreements, ICH GCP, and all applicable regulatory requirements.
If on-site monitoring activities cannot occur, alternative measures will be used. Examples of 
alternative measures are use of technology for off-site monitoring or providing pseudonymized 
copies of source documents to the monitor electronically. The remote source data verification 
will be focused on critical efficacy data and important safety data.
Records retention and audits


CONFIDENTIAL
Protocol J2X-MC-PYAJ
40
Records and documents, including signed ICFs, pertaining to the conduct of this study must be 
retained by the investigator for the time period outlined in the CTA unless local regulations or 
institutional policies require a longer retention period.
No records may be destroyed during the retention period without the written approval of the 
sponsor. No records may be transferred to another location or party without written notification 
to the sponsor.
The sponsor or its representatives will periodically check a sample of the participant data 
recorded against source documents at the study site. The study may be audited by the sponsor or 
its representatives, and by regulatory agencies at any time. Investigators will be given notice 
before an audit occurs.
Data capture system
The investigator is responsible for ensuring the accuracy, completeness, legibility, and timeliness 
of the data reported to the sponsor.
An EDC system will be used in this study for the collection of CRF data. The investigator 
maintains a separate source for the data entered by the investigator or designee into the 
sponsor-provided EDC system.
Only symptom assessments might be directly recorded by the investigator site personnel or a 
delegate into the EDC. The directly entered data will serve as source documentation. The 
investigator will not maintain an original, separate, written, or electronic record of these data. A 
certified copy of the respective data entry will be downloaded by the investigator for retention.
The investigator is responsible for the identification of any data to be considered source and for 
the confirmation that data reported are accurate and complete by signing the CRF.
Data collected via the sponsor-provided data capture systems will be stored at third parties. The 
investigator will have continuous access to the data during the study and until decommissioning 
of the data capture systems. Prior to decommissioning, the investigator will receive an archival 
copy of pertinent data for retention.
Data managed by a central vendor, such as laboratory test data, will be stored electronically in 
the central vendor’s database system, and reports will be provided to the investigator for review 
and retention. Data will subsequently be transferred from the central vendor to the sponsor data 
warehouse.
Data from complaint forms submitted to sponsor will be encoded and stored in the global 
product complaint management system.
10.1.7.
Source Documents
Source documents provide evidence for the existence of the participant and substantiate the 
integrity of the data collected. Source documents are filed at the investigator’s site.
Data reported on the CRF that are transcribed from source documents must be consistent with 
the source documents or the discrepancies must be explained. The investigator may need to 
request previous medical records or transfer records, depending on the study. Current medical 
records must be available.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
41
The definition of what constitutes source data can be found in Section 10.1.6.
10.1.8.
Study and Site Start and Closure
The study start date is the date on which the clinical study will be open for recruitment of 
participants.
Site Closure
The sponsor designee reserves the right to close the study site or terminate the study at any time 
for any reason at the sole discretion of the sponsor. Study sites will be closed upon study 
completion. A study site is considered closed when all required documents and study supplies 
have been collected and a study-site closure visit has been performed.
The investigator may initiate study-site closure at any time, provided there is reasonable cause 
and enough notice is given in advance of the intended termination.
Reasons for the early closure of a study site by the sponsor or investigator may include but are 
not limited to

failure of the investigator to comply with the protocol, the requirements of the IRB/IEC 
or local health authorities, the sponsor’s procedures, or GCP guidelines

inadequate recruitment of participants by the investigator, or

discontinuation of further study intervention development.
If the study is prematurely terminated or suspended, the sponsor shall promptly inform the 
investigators, the IECs/IRBs, the regulatory authorities, and any contract research organization(s) 
used in the study of the reason for termination or suspension, as specified by the applicable 
regulatory requirements. The investigator shall promptly inform the participants and assure 
appropriate participant therapy and/or follow-up.
10.1.9.
Publication Policy
In accordance with the sponsor’s publication policy, the results of this study will be submitted 
for publication by a peer-reviewed journal if the results are deemed to be of significant medical 
importance.
10.1.10.
Investigator Information
Physicians with specialties, including, but not limited to infectious disease, acute or critical care, 
pulmonary disease, immunology, or other appropriate specialties may participate as 
investigators.
10.1.11.
Long-Term Sample Retention
Not applicable


CONFIDENTIAL
Protocol J2X-MC-PYAJ
42
10.2.
Appendix 2: Adverse Events: Definitions and Procedures for 
Recording, Evaluating, Follow-Up, and Reporting
10.2.1.
Definition of AE
AE Definition

An AE is any untoward medical occurrence in a patient or clinical study participant, 
temporally associated with the use of study intervention, whether or not considered 
related to the study intervention.

NOTE: An AE can therefore be any unfavorable and unintended sign (including an 
abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally 
associated with the use of study intervention.
Events Meeting the AE Definition

Any abnormal laboratory test results (hematology, clinical chemistry, or urinalysis) or 
other safety assessments (e.g., ECG, radiological scans, and vital signs measurements), 
including those that worsen from baseline, considered clinically significant in the 
medical and scientific judgment of the investigator (i.e., not related to progression of 
underlying disease).

Exacerbation of a chronic or intermittent preexisting condition including either an 
increase in frequency and/or intensity of the condition.

New conditions detected or diagnosed after study intervention administration even 
though it may have been present before the start of the study.

Signs, symptoms, or the clinical sequelae of a suspected drug-drug interaction.

Signs, symptoms, or the clinical sequelae of a suspected overdose of either study 
intervention or a concomitant medication. Overdose per se will not be reported as an 
AE or SAE unless it is an intentional overdose taken with possible suicidal/self-
harming intent. Such overdose should be reported regardless of sequelae. 

“Lack of efficacy” or “failure of expected pharmacological action” per se will not be 
reported as an AE or SAE. Such instances will be captured in the efficacy assessments. 
However, the signs, symptoms, and/or clinical sequelae resulting from lack of efficacy 
will be reported as AE or SAE if they fulfill the definition of an AE or SAE. 
Events NOT Meeting the AE Definition

The following study-specific clinical events related to COVID-19 are exempt from 
adverse event reporting unless the investigator deems the event to be related to the 
administration of study intervention:
o
hypoxemia due to COVID-19 requiring supplemental oxygen
o
hypoxemia due to COVID-19 requiring non-invasive ventilation or high flow 
oxygen devices, and


CONFIDENTIAL
Protocol J2X-MC-PYAJ
43
o
respiratory failure due to COVID-19 requiring invasive mechanical ventilation 
or ECMO.

Any clinically significant abnormal laboratory findings or other abnormal safety 
assessments which are associated with the underlying disease, unless judged by the 
investigator to be more severe than expected for the participant’s condition.

The disease/disorder being studied or expected progression, signs, or symptoms of the 
disease/disorder being studied, unless more severe than expected for the participant’s 
condition.

Medical or surgical procedure (e.g., endoscopy and appendectomy): the condition that 
leads to the procedure is the AE.

Situations in which an untoward medical occurrence did not occur (social and/or 
convenience admission to a hospital).

Anticipated day-to-day fluctuations of preexisting disease(s) or condition(s) present or 
detected at the start of the study that do not worsen.
10.2.2.
Definition of SAE
If an event is not an AE per definition above, then it cannot be an SAE even if serious conditions 
are met (e.g., hospitalization for signs/symptoms of the disease under study, death due to 
progression of disease).
An SAE is defined as any untoward medical occurrence that, at any dose:
a.
Results in death
b.
Is life-threatening
The term “life-threatening” in the definition of “serious” refers to an event in which the 
participant is at risk of death at the time of the event. It does not refer to an event, which 
hypothetically might have caused death, if it were more severe.
c.
Requires inpatient hospitalization or prolongation of existing hospitalization

In general, hospitalization signifies that the participant has been admitted to hospital
for observation and/or treatment that would not have been appropriate in the 
physician’s office or outpatient setting. Complications that occur during hospitalization 
are AEs. If a complication prolongs hospitalization or fulfills any other serious criteria, 
the event is serious. When in doubt as to whether “hospitalization” occurred or was 
necessary, the AE should be considered serious.

Hospitalization for elective treatment of a preexisting condition that did not worsen 
from baseline is not considered an AE.
d.
Results in persistent disability/incapacity

The term disability means a substantial disruption of a person’s ability to conduct 
normal life functions.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
44

This definition is not intended to include experiences of relatively minor medical 
significance, such as uncomplicated headache, nausea, vomiting, diarrhea, influenza, 
and accidental trauma (e.g., sprained ankle), which may interfere with or prevent 
everyday life functions but do not constitute a substantial disruption.
e.
Is a congenital anomaly/birth defect
f.
Other situations:

Medical or scientific judgment should be exercised in deciding whether SAE reporting 
is appropriate in other situations such as important medical events that may not be 
immediately life-threatening or result in death or hospitalization but may jeopardize the 
participant or may require medical or surgical intervention to prevent 1 of the other 
outcomes listed in the above definition. These events should usually be considered 
serious.

Examples of such events include invasive or malignant cancers, intensive treatment in 
an emergency room or at home for allergic bronchospasm, blood dyscrasias or 
convulsions that do not result in hospitalization, or development of drug dependency or 
drug abuse.
10.2.3.
Recording and Follow-Up of AE and/or SAE
AE and SAE Recording

When an AE or SAE occurs, it is the responsibility of the investigator to review all 
documentation (e.g., hospital progress notes, laboratory reports, and diagnostics 
reports) related to the event.

The investigator will then record all relevant AE or SAE information in the CRF.

It is not acceptable for the investigator to send photocopies of the participant’s medical 
records to Sponsor or designee in lieu of completion of the AE or SAE CRF page.

There may be instances when copies of medical records for certain cases are requested 
by Sponsor or designee. In this case, all participant identifiers, with the exception of 
the participant number, will be redacted on the copies of the medical records before 
submission to Sponsor or designee.

The investigator will attempt to establish a diagnosis of the event based on signs, 
symptoms, and/or other clinical information. Whenever possible, the diagnosis (not the 
individual signs/symptoms) will be documented as the AE or SAE.
Assessment of Intensity
The investigator will make an assessment of intensity for each AE and SAE reported during 
the study and assign it to 1 of the following categories, which together with serious (i.e., SAE) 
criteria on the AE CRF (“results in death” and “life-threatening”), are aligned with the DAIDS 
Table for Grading the Severity of Adult and Pediatric Adverse Events, version 2.1 (July 2017).


CONFIDENTIAL
Protocol J2X-MC-PYAJ
45
Mild: Mild symptoms causing no or minimal interference with usual social and functional 
activities, with intervention not indicated.
Moderate: Moderate symptoms causing greater than minimal interference with usual 
social and functional activities, with intervention indicated.
Severe: Severe symptoms causing inability to perform usual social and functional 
activities, with intervention or hospitalization indicated.
An event is defined as “serious” when it meets at least 1 of the predefined outcomes as 
described in the definition of an SAE, NOT when it is rated as severe.
Assessment of Causality

The investigator is obligated to assess the relationship between study intervention and 
each occurrence of each AE or SAE.

A “reasonable possibility” of a relationship conveys that there are facts, evidence, 
and/or arguments to suggest a causal relationship, rather than a relationship cannot be 
ruled out.

The investigator will use clinical judgment to determine the relationship.

Alternative causes, such as underlying disease(s), concomitant therapy, and other risk 
factors, as well as the temporal relationship of the event to study intervention 
administration will be considered and investigated.

The investigator will also consult the IB and/or Product Information, for marketed 
products, in his or her assessment.

For each AE or SAE, the investigator must document in the medical notes that he or 
she has reviewed the AE or SAE and has provided an assessment of causality.

There may be situations in which an SAE has occurred and the investigator has 
minimal information to include in the initial report to Sponsor or designee. However, it 
is very important that the investigator always make an assessment of causality for 
every event before the initial transmission of the SAE data to Sponsor or designee.

The investigator may change his or her opinion of causality in light of follow-up 
information and send an SAE follow-up report with the updated causality assessment.

The causality assessment is 1 of the criteria used when determining regulatory 
reporting requirements.
Follow-Up of AEs and SAEs

The investigator is obligated to perform or arrange for the conduct of supplemental 
measurements and/or evaluations as medically indicated or as requested by Sponsor or 
designee to elucidate the nature and/or causality of the AE or SAE as fully as possible. 
This may include additional laboratory tests or investigations, histopathological 
examinations, or consultation with other health care professionals.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
46

If a participant dies during participation in the study or during a recognized follow-up 
period, the investigator will provide Sponsor or designee with a copy of any 
postmortem findings including histopathology. 

New or updated information will be recorded in the originally completed CRF.

The investigator will submit any updated SAE data to Sponsor or designee within 24 
hours of receipt of the information. 
10.2.4.
Reporting of SAEs
SAE Reporting via an Electronic Data Collection Tool

The primary mechanism for reporting an SAE will be the electronic data collection 
tool.

If the electronic system is unavailable, then the site will use the paper SAE data 
collection tool (see next section) in order to report the event within 24 hours.

The site will enter the SAE data into the electronic system as soon as it becomes 
available.

After the study is completed at a given site, the electronic data collection tool will be 
taken off-line to prevent the entry of new data or changes to existing data.

If a site receives a report of a new SAE from a study participant or receives updated 
data on a previously reported SAE after the electronic data collection tool has been 
taken off-line, then the site can report this information on a paper SAE form (see next 
section) or to the sponsor by telephone.

Contacts for SAE reporting can be found in site training documents.
SAE Reporting via Paper CRF

Facsimile transmission of the SAE paper CRF is the preferred method to transmit this 
information to the sponsor.

Initial notification via telephone does not replace the need for the investigator to 
complete and sign the SAE CRF pages within the designated reporting time frames.

Contacts for SAE reporting can be found in site training documents.
10.2.5.
Medication Error
FDA defines medication error as any preventable event that may cause or lead to inappropriate 
medication use or patient harm while the medication is in the control of a healthcare provider, 
patient, or consumer (FDA 2020b).


CONFIDENTIAL
Protocol J2X-MC-PYAJ
47
10.3.
Appendix 3: Contraceptive Guidance and Collection of Pregnancy 
Information
Definitions:
Women
Woman of Childbearing Potential
A woman is considered fertile following menarche and until becoming postmenopausal unless 
permanently sterile (see below).
If fertility is unclear (e.g., amenorrhea in adolescents or athletes) and a menstrual cycle cannot be 
confirmed before first dose of study intervention, additional evaluation should be considered.
Woman not of Childbearing Potential
Women in the following categories are not considered women of childbearing potential:
1. premenarchal
2. premenopausal female with either
a.
documented hysterectomy
b. documented bilateral salpingectomy, or
c.
documented bilateral oophorectomy.
For individuals with permanent infertility due to an alternate medical cause other than the above, 
(e.g., Müllerian agenesis, androgen insensitivity), investigator discretion should be applied to 
determining study entry.
Note: Determination can come from the site personnel’s review of the participant’s medical 
records, medical examination, or medical history interview.
3. Postmenopausal female is defined as, women with:
d. 12 months of amenorrhea for women >55, with no need for FSH
e.
12 months of amenorrhea for women >40 years old with FSH ≥40 mIU/mL and 
no other medical condition such as anorexia nervosa and not taking medications 
during the amenorrhea (e.g., oral contraceptives, hormones, gonadotropin 
releasing hormone, anti-estrogens, selective estrogen receptor modulators 
(SERMs), or chemotherapy that induced amenorrhea)
Participation in the Study
Women of child-bearing potential and not of child-bearing potential may participate in this 
study.
Women of child-bearing potential must test negative for pregnancy prior to initiation of 
treatment as indicated by a negative urine pregnancy test at the screening visit.
Women of child-bearing potential who are completely abstinent or in a same sex relationship, as 
part of their preferred and usual lifestyle, must agree to either remain abstinent or stay in a same 
sex relationship without sexual relationships with males.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
48
All other women of child-bearing potential must agree to use 2 forms of effective contraception, 
where at least one form is highly effective (less than 1% failure rate), for the entirety of the 
study.
Abstinence or contraception must continue for 90 days after the last dose of intervention.
Acceptable Methods of Contraception
Highly effective methods of contraception (less than 1% failure rate) comprise but are not 
limited to

combination oral contraceptives

implanted contraceptives, or 

intrauterine devices. 
Effective methods of contraception comprise but are not limited to diaphragms with spermicide 
or cervical sponges.
Not Acceptable Methods of Contraception
Use of male and female condoms as a double barrier method is not considered acceptable due to 
the high failure rate when these barrier methods are combined.
Barrier protection methods without concomitant use of a spermicide are not an effective or 
acceptable method of contraception.
Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods), 
declaration of abstinence just for the duration of a trial, and withdrawal are not acceptable 
methods of contraception.
Men
Men, regardless of their fertility status, must agree to either remain abstinent (if this is their 
preferred and usual lifestyle) or use condoms as well as one additional highly effective method 
of contraception (less than 1% failure rate) or effective method of contraception with non-
pregnant women of child bearing potential partners for the duration of the study and until their 
plasma concentrations are below the level that could result in a relevant potential exposure to a 
possible fetus, predicted to be 90 days after the last dose.
Men with pregnant partners should use condoms during intercourse for the duration of the study 
and until the end of estimated relevant potential exposure to the fetus, predicted to be 90 days 
after the last dose.
Acceptable Methods of Contraception
Highly effective methods of contraception (less than 1% failure rate) comprise, but are not 
limited to

combination oral contraceptives

implanted contraceptives, or 

intrauterine devices. 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
49
Effective methods of contraception comprise but are not limited to diaphragms with spermicide 
or cervical sponges.
Men and their partners may choose to use a double-barrier method of contraception that must 
include use of a spermicide.
Other Guidance
Men should refrain from sperm donation for the duration of the study and until their plasma 
concentrations are below the level that could result in a relevant potential exposure to a possible 
fetus, predicted to be 90 days after the last dose. 
Collection of Pregnancy Information
Male participants with partners who become pregnant
The investigator will attempt to collect pregnancy information on any male participant’s female 
partner who becomes pregnant while the male participant is in this study. This applies only to 
male participants who receive study intervention.
After obtaining the necessary signed informed consent and assent (if applicable) from the 
pregnant female partner directly, the investigator will record pregnancy information on the 
appropriate form and submit it to the sponsor within 24 hours of learning of the partner’s 
pregnancy. 
The female partner will also be followed to determine the outcome of the pregnancy. Information 
on the status of the mother and child will be forwarded to the sponsor. Generally, this 
information will include a follow-up of at least 5 half-lives after last exposure or birth. Any 
termination of the pregnancy will be reported including fetal status (presence or absence of 
anomalies) and indication for the procedure. 
Female participants who become pregnant
The investigator will collect pregnancy information on any female participant who becomes 
pregnant while participating in this study. The initial information will be recorded on the 
appropriate form and submitted to the sponsor within 24 hours of learning of a participant's 
pregnancy. 
The participant will be followed to determine the outcome of the pregnancy. The investigator 
will collect follow-up information on the participant and the neonate and the information will be 
forwarded to the sponsor. Generally, this information will include a follow-up of at least 5 half-
lives after last exposure or birth. Any termination of pregnancy will be reported, including fetal 
status (presence or absence of anomalies) or indication for the procedure.
While pregnancy itself is not considered to be an AE or SAE, any pregnancy complication or 
elective termination of a pregnancy for medical reasons will be reported as an AE or SAE. 
A spontaneous abortion (occurring at <20 weeks gestational age) or still birth (occurring at >20
weeks gestational age) is always considered to be an SAE and will be reported as such. 
Any post-study pregnancy-related SAE considered reasonably related to the study intervention 
by the investigator will be reported to the sponsor as described in Section 8.3.4. While the 


CONFIDENTIAL
Protocol J2X-MC-PYAJ
50
investigator is not obligated to actively seek this information in former study participants, he or 
she may learn of an SAE through spontaneous reporting.


CONFIDENTIAL
Protocol J2X-MC-PYAJ
51
10.4.
Appendix 4: Abbreviations
Term
Definition
AC
Assessment committee
ADA
Anti-drug antibody
AE
Adverse event
ADE 
Antibody-dependent enhancement
Assent
Agreement from a child or other individual who is not legally capable of providing 
consent, but who can understand the circumstances and potential risks involved in 
participating in a study.
BMI
Body mass index
Complaint
A complaint is any written, electronic, or oral communication that alleges deficiencies 
related to the identity, quality, purity, durability, reliability, safety or effectiveness, or 
performance of an intervention.
Compliance
Adherence to all study-related, good clinical practice (GCP), and applicable regulatory 
requirements.
CRF
Case report form
CRP
Clinical research physician: individual responsible for the medical conduct of the study. 
Responsibilities of the CRP may be performed by a physician, clinical research 
scientist, global safety physician, or other medical officer.
CTA
Clinical trial agreement
DAIDS
Division of AIDS
DMC
Data monitoring committee
ECG
Electrocardiogram
ED
Emergency department
EDC
Electronic data capture
EMR
Electronic medical record
Enroll
The act of assigning a participant to a treatment. Participants who are enrolled in the 
study are those who have been assigned to a treatment.
Enter
Participants entered into a study are those who sign the informed consent form directly 
or through their legally acceptable representatives.
EUA
Emergency Use Authorization
FiO2
Fraction of inspired oxygen in the air


CONFIDENTIAL
Protocol J2X-MC-PYAJ
52
GCP
Good clinical practice
IB
Investigator’s Brochure
ICF
Informed consent form
ICH
International Council for Harmonisation
IMP
Investigational Medicinal Product
Informed consent
A process by which a participant voluntarily confirms his or her willingness to 
participate in a particular study, after having been informed of all aspects of the study 
that are relevant to the participant’s decision to participate. Informed consent is 
documented by means of a written, signed, and dated informed consent form.
Interim analysis
An interim analysis is an analysis of clinical study data, separated into treatment groups, 
that is conducted before the final reporting database is created/locked.
Intervention
A pharmaceutical form of an active ingredient or placebo being tested or used as a 
reference in a clinical trial, including products already on the market when used or 
assembled (formulated or packaged) in a way different from the authorized form, or 
marketed products used for an unauthorized indication, or marketed products used to 
gain further information about the authorized form.
IRB/IEC
Institutional Review Boards/Independent Ethics Committees
IV
Intravenous
IWRS
Interactive web-response system
Legal representative
An individual or judicial or other body authorized under applicable law to consent, on 
behalf of a prospective participant, to their participation in the clinical study.
Medication error
A medication error is any preventable event that may cause or lead to inappropriate 
medication use or patient harm while the medication is in the control of a healthcare 
provider, patient, or consumer (FDA 2020b).
Mabs
Monoclonal antibodies
NP
Nasopharyngeal
Participant
Equivalent to CDISC term “subject”: an individual who participates in a clinical trial, 
either as recipient of an investigational medicinal product or as a control
PK/PD
Pharmacokinetics/pharmacodynamics
PS
Propensity score
SAE
Serious adverse event
SAP
Statistical analysis plan
SARS
Severe acute respiratory syndrome


CONFIDENTIAL
Protocol J2X-MC-PYAJ
53
Screen
The act of determining if an individual meets minimum requirements to become part of 
a pool of potential candidates for participation in a clinical study. 
SpO2
Saturation of peripheral oxygen


CONFIDENTIAL
Protocol J2X-MC-PYAJ
54
11.
References
Aoki FY, Macleod MD, Paggiaro P, et al. Early administration of oral oseltamivir increases the 
benefits of influenza treatment. J Antimicrob Chemother. 2003;51(1):123-129.
https://doi.org/10.1093/jac/dkg007.
Austin PC. A comparison of 12 algorithms for matching on the propensity score. Stat Med.
2014;33(6):1057-1069. https://doi.org/10.1002%2Fsim.6004.
D’Agostino RB. Propensity score methods for bias reduction in the comparison of a treatment to 
a non-randomized control group. Stat Med. 1998;17(19):2265-2281.
Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse 
Events. National Institute of Allergy and Infectious Diseases. National Institutes of Health. US 
Department of Health and Human Services. Corrected version 2.1. July 2017. Accessed 
October 05, 2020. https://rsc.niaid.nih.gov/sites/default/files/daidsgradingcorrectedv21.pdf.
Duan K, Liu B, Li, C, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 
patients. PNAS. 2020. https://doi.org/10.1073/pnas.2004168117.
[FDA 2020a] U.S. Food and Drug Administration. Fact Sheet for Health Care Providers 
Emergency Use Authorization (EUA) of Bamlanivimab. Accessed December 18, 2020. 
https://www.fda.gov/media/143603/download.
[FDA 2020b] U.S. Food and Drug Administration. Medication Errors Related to CDER-
Regulated Drug Products. Accessed December 17, 2020. https://www.fda.gov/drugs/drug-
safety-and-availability/medication-errors-related-cder-regulated-drug-
products#:~:text=FDA%20defines%20a%20medication%20error,provider%2C%20patient%2
C%20or%20consumer.
FDA resource page. COVID-19: Developing drugs and biological products for treatment or 
prevention guidance for industry. Food and Drug Administration web site. Accessed October 
05, 2020. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/covid-
19-developing-drugs-and-biological-products-treatment-or-prevention.
Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 
and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181:1-10. 
doi:10.1016/j.cell.2020.02.052.
Liu Y, Sun W, Li J, et al. Clinical features and progression of acute respiratory distress syndrome 
in coronavirus disease 2019. medRxiv. Posted February 27, 2020. Preprint.
https://doi.org/10.1101/2020.02.17.20024166. 
Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically Ill patients with COVID-19 with 
convalescent plasma. JAMA. Published March 27, 2020. doi:10.1001/jama.2020.4783.


Leo Document ID = 8ac6f859-6b0b-4bf6-8d30-2c0017eaee3f
Approver: 
Approval Date & Time: 18-Dec-2020 23:02:04 GMT
Signature meaning: Approved
Approver: 
Approval Date & Time: 18-Dec-2020 23:42:05 GMT
Signature meaning: Approved
PPD
PPD

SAP_001.pdf: 
 
 
 
 
 
Statistical Analysis Plan: J2X-MC-PYAJ (version 3) 
 
 
A Prospective Cohort Study to Evaluate the Real World Effectiveness 
of Bamlanivimab in Participants with Mild to Moderate COVID-19 at 
High Risk for Progressing to Severe. 
 
 
NCT04701658 
 
 
Approval Date: 13-Aug-2021 


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
1
LY3819253
Statistical Analysis Plan:
Protocol J2X-MC-PYAJ: A Prospective Cohort Study to Evaluate 
the Real World Effectiveness of Bamlanivimab in Participants with 
Mild to Moderate COVID-19 at High Risk for Progressing to Severe
Confidential Information
The information contained in this document is confidential and is intended for the use of clinical investigators.  It is the property of 
Eli Lilly and Company or its subsidiaries and should not be copied by or distributed to persons not involved in the clinical 
investigation of LY3819253 and LY3832479, unless such persons are bound by a confidentiality agreement with Eli Lilly and 
Company or its subsidiaries. 
Note to Regulatory Authorities:  This document may contain protected personal data and/or commercially confidential 
information exempt from public disclosure.  Eli Lilly and Company requests consultation regarding release/redaction prior to any 
public release.  In the United States, this document is subject to Freedom of Information Act (FOIA) Exemption 4 and may not be 
reproduced or otherwise disseminated without the written approval of Eli Lilly and Company or its subsidiaries.
LY3819253 (bamlanivimab)
Eli Lilly and Company
Indianapolis, Indiana USA 46285
J2X-MC-PYAJ
Phase 2
Approval Date: 13-Aug-2021 GMT


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
2
LY3819253
Table of Contents
Table of Contents ......................................................................................................................2
Table of Abbreviations..............................................................................................................3
1.
Revision History .........................................................................................................5
2.
Objectives and Endpoints...........................................................................................9
3.
Research Design........................................................................................................10
3.1.
Summary of Study Design..........................................................................................10
3.2.
Data Collection...........................................................................................................11
3.3.
Study Population ........................................................................................................11
3.3.1.
Selection Criteria........................................................................................................11
3.3.2.
Exclusion Criteria:......................................................................................................13
3.4.
Patient Group .............................................................................................................14
3.5.
Endpoints ...................................................................................................................14
3.6.
Study Therapies..........................................................................................................15
3.7.
Variables/Measures ....................................................................................................15
4.
Statistical Analyses ...................................................................................................18
4.1.
General Considerations...............................................................................................18
4.2.
Participant Dispositions ..............................................................................................18
4.3.
Populations for Analyses ............................................................................................18
4.4.
Primary Analyses and Methodology ...........................................................................18
4.5.
Secondary Analyses....................................................................................................19
4.6.
Handling of Missing Data or Dropouts .......................................................................22
4.7.
Other Analyses ...........................................................................................................23
4.8.
Interim Analyses.........................................................................................................23
4.9.
Changes to Protocol-Planned Analyses.......................................................................23
5.
References.................................................................................................................24


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
3
LY3819253
Table of Abbreviations
Term
Definition
AE
adverse event
BMI
body mass index
BP
blood pressure
CDC
Centers for Disease Control and Prevention
CI
confidence interval
CRF
case report form
COVID-19
coronavirus disease 2019
ED
emergency department
ER
emergency room
EDC
electronic data capture 
EMR
electronic medical record
EUA
emergency use authorization
FDA
Food and Drug Administration
ICF
informed consent form
IQR
Interquartile range
IgG
immunoglobulin G
IPD
important protocol deviation
ISR
infusion site reaction
IV
Intravenous
MedDRA
Medical Dictionary for Regulatory Activities
MSSO
MedDRA Maintenance and Support Services Organization
NM Health System
New Mexico Health System
PT
Preferred Term
RT-PCR
reverse transcription-polymerase chain reaction
SAE
serious adverse event


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
4
LY3819253
SAP
statistical analysis plan
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
SMQ
Standardized MedDRA Query
SoA
schedule of activities
SOC
System Organ Class
SpO2
saturation of peripheral oxygen


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
5
LY3819253
1.
Revision History
The first version of the Statistical Analysis Plan (SAP) for J2X-MC-PYAJ was approved prior to 
first patient visit.
Overall Rationale for the Revision on Version 2
Due to low enrollment, the minimum sample size required for the primary objective analysis 
could not be met; therefore, enrollment into the PYAJ study was terminated early, on 
31 March 2021, due to infeasibility. Follow-up on patients treated with bamlanivimab enrolled in 
the study continued for 90 days, per protocol. 
Based on the study’s inability to enroll sufficient participants, no control group was utilized; 
therefore, no comparative analyses was conducted.  All analyses were descriptive in nature and 
conducted only on bamlanivimab-treated participants, based on Electronic Data Capture (EDC)
and Electronic Medical Record (EMR) data. The revisions in the SAP Version 2 updated
analysis population and analysis methods reflect these decisions.
The SAP Version 2 was approved prior to the database lock. The changes incorporated in 
Version 2 are summarized as follows:
Section No. and Name
Description of Change
Brief Rationale
Table of Abbreviations

Added and removed abbreviations
Propensity score matching 
method utilizing control 
group will not be conducted. 
Clarification of text.
2. Objectives and Endpoints

Removed “compared to external controls” 
from all objectives 

Added time periods, Days 60 and 90, to the 
primary objectives 

Replaced death with all-cause death in the 
primary objectives

Replaced ED with ER
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
Changing from COVID-19-
related death to all-cause 
death due to inability to 
distinguish the cause of 
death from EMR data.
To distinguish with early 
discontinuation.
3.1. Summary of Study 
Design

Removed language regarding matched or 
external control group

Added screening 
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
3.2. Data Collection 

Removed language regarding matched or 
external control group
Comparative analyses 
utilizing the control group 
will not be conducted.
Clarification of text.
3.3. Sample Size 
Determination

Updated sample size

Changed power to precision estimation

Removed power for subgroup analyses
Alignment with primary 
objective.
Clarification of text.
3.4.1. Selection Criteria

Removed insurance 
Not relevant.


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
6
LY3819253
Section No. and Name
Description of Change
Brief Rationale
3.6. Endpoints

Removed language regarding matched or 
external control group

Updated endpoints to reflect the objectives
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
3.7. Study Therapies 

Removed language regarding matched or 
external control group
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
3.8. Variables/Measures

Removed language regarding matched or 
external control group

Clarified the definition of the study variables
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
General Considerations

Removed language regarding matched or 
external control group
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
Populations Analysis

Removed study populations related to 
matched controls  

Updated population to include BAM-treated 
patients only
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
4.4.1. Pre-Matching 
Identification of Risk Factors 
as Matching Covariates
4.4.2. Primary Efficacy 
Outcome Analysis: COVID-
19-Related Hospitalization or 
Death up to Day 29

Removed as the control group and 
propensity score methods are not applicable 
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
4.4.3. Primary Efficacy 
Outcome Analysis: COVID-
19-Related Hospitalization or 
all-cause Death up to Days
29, 60, and 90

Removed all comparative effectiveness 
analyses

Updated the analyses methods to descriptive 
Clarification of text 
describing methodology.
4.4.4. Sensitivity Analyses 
for the Primary Objective

Removed all comparative effectiveness 
analyses

Updated the analyses methods to descriptive
Clarification of text 
describing methodology
4.5. Secondary Analyses

Expanded the safety analyses

Updated text
Clarification of text 
describing methodology
4.6. Heading of Missing Data 
or Dropouts

Removed context related to the control 
group
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
5. References 

Removed all references related to propensity 
score methods 
Comparative analyses 
utilizing the control group 
will not be conducted. 
Clarification of text.
Abbreviations: BAM = bamlanivimab; ED = emergency department; ER = emergency room; No. = number.


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
7
LY3819253
Overall Rationale for the Revision on Version 3
Due to limitations in the availability of some data elements in the EMR, this SAP Version 3 
modified variable definitions for prior and concomitant therapy. Other changes included updated 
analyses for vital signs, removal of hospitalization and healthcare utilization events collected 
from EDC, and removal of subgroup analyses due to low sample size.
This SAP Version 3 supersedes the statistical plans described in the SAP V2. It will be approved 
prior to the final database lock. 
The changes incorporated in Version 3 are summarized as follows:
Section No. and Name
Description of Change
Brief Rationale
Entire SAP

Corrected study alias name J2W-MC-
PYAJ to J2X-MC-PYAJ
Typo
Entire SAP

Replaced “by Days 29, 60, and 90” to “up 
to Days 29, 60, and 90”
Language changed to avoid confusion 
Entire SAP

Defined acronyms at first presentation 
throughout the document
To clarify in-text acronyms for ease of 
reading
3.2. Data collection

Reworded the description of data 
collection 
Clarification
3.5. Endpoints 

Updated the follow-up days on Figure 3.2
Language changed to avoid confusion 
3.7. Variables/Measures

Changed height unit from m to cm 

Added data source “from EMR” to age 
variable

Added the following additional COVID-19 
symptoms:
o
chills
o
loss of sense of taste 
o
loss of sense of smell 
o
fatigue

Specified the time frame “during 1 year 
prior to the infusion” for preexisting 
conditions and medical history

Changed variable “prior treatments of 
special interest within the 30 days” to 
“Treatments of special interest prescribed 
within 30 days prior to infusion”

Specified “other investigational 
treatments” to include ivermectin, 
COVID-19 vaccine, and oxygen

Changed variable “Concomitant 
medications” to “Prior or concomitant 
therapy 90 days before and 90 days after 
infusion”
o
Removed “other investigational 
treatments” 

Added time frame “during 10 days prior 
infusion” for Procedures of special interest 

Removed “ongoing hospital medical care”
from Procedures of special interest 
Data format in EMR
Clarification
According to the FDA COVID guidance 
(September, 2020)
Clarification
Due to incomplete medication days of supply
data, prior treatments cannot be well-defined. 
Changed to treatment prescribed. 
Included definition of “other investigational 
treatments”
Due to incomplete medication days of supply
data, concomitant medication cannot be well-
defined.
Study team decision due to concomitant 
medication can’t be well-defined.
Clarification 
Not captured in EMR


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
8
LY3819253

Removed “other respiratory support” from 
Respiratory support

Removed Hospitalization and healthcare 
utilization events
Not captured in EMR
Purposed for EDC quality checking, no plan 
for analysis.
4.5. Secondary analyses

Changed treatment-emergent adverse 
events (TEAEs) to AEs

Removed Hospitalization and healthcare 
utilization events collected from EDC

Added the explanation of how to report 
vital signs
No plan for TEAE
Purposed for EDC quality checking, no plan 
for analysis. 
Clarification
4.7. Other Analyses

Removed previously planned subgroup 
analysis
Due to a small sample size


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
9
LY3819253
2.
Objectives and Endpoints
Table 2.1 shows the primary and secondary objectives and endpoints of the study.
Table 2.1
Protocol-Defined Objectives and Their Endpoints
Objectives
Endpoints
Primary

To determine the proportion of patients 
with COVID-19-related hospitalization 
or all-cause death up to Days 29, 60,
and 90 among bamlanivimab-treated 
participants

Proportion (percentage) of participants 
who experience COVID-19-related
hospitalization (defined as ≥24 hours of 
acute care) or all-cause death up to Days
29, 60, and 90
Secondary

To determine the proportion of patients 
with COVID-19-related hospitalization 
up to 29, 60, and 90 days among 
bamlanivimab-treated participants

Proportion (percentage) of participants 
who experience COVID-19-related 
hospitalization, defined as ≥24 hours of 
acute care, up to Days 29, 60, and 90

To determine the proportion of patients 
with a COVID-19-related ER visit up to
Days 29, 60, and 90 among 
bamlanivimab-treated participants

Proportion (percentage) of participants 
who experience ER visits for 
COVID-19-related causes up to Days 29, 
60, and 90

To describe the safety of bamlanivimab-
treated participants up to Days 29, 60, 
and 90

Incidence (counts and percentage) of 
AEs or SAEs up to Days 29, 60, and 90
Abbreviation: AE = adverse event; COVID-19 = coronavirus disease 2019; ER = emergency room; SAE = serious 
adverse event.


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
10
LY3819253
3.
Research Design 
3.1.
Summary of Study Design
This study is being conducted in the same population as in the emergency use authorization 
(EUA) (FDA 2020).
Study J2X-MC-PYAJ is an open-label, prospective, single-arm observational study in 
participants with mild to moderate COVID-19 (see Section 3.3.1 for criteria). Study participants 
who received a one-time IV infusion of bamlanivimab (LY3819253) within 10 days of symptom 
onset and following the first positive severe acute respiratory syndrome coronavirus 2 (SARS-
CoV-2) test sample collection will then be followed for 90 days to assess any additional medical 
care needed or if hospitalization was required (Figure 3.1).
Abbreviation: EMR = electronic medical record.
a
Screening and Day 1 procedures may occur on the same day.
b
Telephone call 24 hours post-infusion.
c
EMR review and phone call.
Figure 3.1
Study J2X-MC-PYAJ study design.
Screening
Interested participants or their legally authorized representative will sign the appropriate 
informed consent and adolescent assent document(s), as appropriate, prior to completion of any 
procedures.
The investigator will confirm a positive reverse transcription-polymerase chain reaction (RT-
PCR) test or antigen testing confirmation for COVID-19 (if antigen test is accompanied by 
symptoms suggestive of SARS-CoV-2 infection) and complete baseline procedures to confirm 
eligibility per inclusion and exclusion criteria and review criteria for high risk under the EUA.
Treatment and Assessment Period
This is the general sequence of events during the treatment and assessment period:


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
11
LY3819253

participants receive study intervention, and

complete all safety monitoring and post-infusion data collection.
Treated Population Visit Types
The visit types for the Treatment Population table in Section 4.1 of the protocol describes the 
visit types for the treatment population for this study.
Guidelines if a Participant is Hospitalized
If a participant is hospitalized, procedures and assessments will continue per the Schedule of 
Activities (SoA) (Study PYAJ Protocol Section 1.3).
The Description of Discharge from Hospital Scenarios table in Section 4.1 of the protocol 
describes discharge from hospital scenarios if an outpatient is subsequently hospitalized.
Post-treatment 
Post-treatment assessments will be conducted at Days 2, 29, 60, and 90 to assess study
endpoints.
3.2.
Data Collection
Data for bamlanivimab-treated patients will be captured at the infusion visit (Day 1), at 24 hours 
post-infusion (Day 2), and at subsequent follow-up periods (Days 29, 60, and 90). Case report 
form (CRF) data documented within the EDC system will be captured on-site on Day 1 and via 
telephone call on Days 2, 29, 60, and 90. The EMR records will be extracted during 1 year prior 
to and 90 days post the infusion date. 
Sample Size Determination
Due to early termination, the study enrolled 109, rather than the anticipated 500-3000,
bamlanivimab-treated patients. Given that the revised primary objective is to determine the 
proportion of patients with COVID-19-related hospitalization or all-cause death up to 29 days 
among bamlanivimab-treated participants and without the use of a comparison group, the 
observed sample size was 109 participants. This achieved sample size of 109 participants will 
allow for estimating the proportion with a precision of ±4.4% (=1.96*√(p(1-p)/n)) under the 
assumption of normal approximation of a binomial distribution at a 2-sided significance level of 
0.05 and 6% of the true rates of COVID-19-related hospitalization or all-cause death. 
3.3.
Study Population
3.3.1.
Selection Criteria
Prospective approval of protocol deviations to recruitment and enrollment criteria, also known as 
protocol waivers or exemptions, is not permitted.
Due to the criticality of participant health, verbal interview of the potential participant, or their 
legal representative or family member, may be the source for disease characteristics and medical 
history, unless otherwise specified within the eligibility criteria.
Inclusion Criteria:
Participants are eligible to be included in the study only if all of the following criteria apply: 


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
12
LY3819253
Age
1. Are ≥12 years of age at the time of screening
Disease Characteristics
2. Are currently not hospitalized
3. Have one or more mild or moderate COVID-19 symptoms (FDA 2020)
i.
Fever
ii.
Cough
iii.
Sore throat
iv.
Malaise
v.
Headache
vi.
Muscle pain
vii.
Gastrointestinal symptoms, or
viii.
Shortness of breath with exertion.
4. Must have first positive SARS-CoV-2 viral infection determination and as soon as 
possible within 10 days of symptom onset
5. Are males or non-breastfeeding females Reproductive and Contraceptive agreements and 
guidance is provided in the protocol Section 10.3, Appendix 3. Contraceptive use by 
males or females should be consistent with local regulations for those participating in 
clinical studies
Study Procedures
6. Understand and agree to comply with planned study procedures
Informed Consent
7. The participant or legally authorized representative gives signed informed consent and/or 
assent as described in the protocol Section 10.1.3, which includes compliance with the 
requirements and restrictions listed in the Informed Consent Form (ICF) and in the 
protocol
High risk as defined per EUA fact sheet (FDA 2020)
8. For example, participants who meet at least 1 of the following criteria: 

Have a body mass index (BMI) ≥35

Have chronic kidney disease

Have diabetes

Have immunosuppressive disease

Are currently receiving immunosuppressive treatment

Are ≥65 years of age

Are ≥55 years of age AND have
•
cardiovascular disease, OR
•
hypertension, OR
•
chronic obstructive pulmonary disease or other chronic respiratory disease.

Are 12–17 years of age AND have


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
13
LY3819253
•
BMI ≥85th percentile for their age and gender based on Centers for Disease 
Control and Prevention (CDC) growth charts, 
https://www.cdc.gov/growthcharts/clinical_charts.htm, OR
•
sickle cell disease, OR
•
congenital or acquired heart disease, OR
•
neurodevelopmental disorders, for example, cerebral palsy, OR
•
a medical-related technological dependence, for example, tracheostomy, 
gastrostomy, or positive pressure ventilation (not related to COVID-19), OR
•
asthma, reactive airway or other chronic respiratory disease that requires daily 
medication for controls.
3.3.2.
Exclusion Criteria:
Limitations of Benefit and Potential for Risk in Patients with Severe COVID-19
Benefit of treatment with bamlanivimab has not been observed in patients hospitalized due to 
COVID-19. Monoclonal antibodies, such as bamlanivimab, may be associated with worse 
clinical outcomes when administered to hospitalized patients with COVID-19 requiring high 
flow oxygen or mechanical ventilation. More specifically, participants are excluded from the 
study if any of the following criteria apply:
Medical Conditions
9. Participants who:
a) are hospitalized due to COVID-19,
b) require oxygen therapy due to COVID-19, OR
c) require an increase in baseline oxygen flow rate due to COVID-19 in those on chronic 
oxygen therapy due to underlying non-COVID-19-related comorbidity.
10. Have SpO2 ≤90% on room air or PaO2/FiO2 <300, respiratory rate ≥30 per minute, heart 
rate ≥125 per minute (FDA 2020) 
11. Have body weight <40kg
12. Require mechanical ventilation or anticipated impending need for mechanical ventilation
13. Have known allergies to any of the components used in the formulation of the 
interventions
14. Suspected or proven serious, active bacterial, fungal, viral, or other infection (besides 
COVID-19) that in the opinion of the investigator could constitute a risk when taking 
intervention
15. Have any comorbidity requiring surgery within <7 days, or that is considered life-
threatening within 29 days
16. Have any serious concomitant systemic disease, condition, or disorder that, in the opinion 
of the investigator, should preclude participation in this study
Other Exclusions
17. Have a history of a positive SARS-CoV-2 serology test
18. Have a history of a positive SARS-CoV-2 test prior to the one serving as eligibility for 
this study


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
14
LY3819253
19. Have received an investigational intervention for SARS-CoV-2 prophylaxis within 30 
days before dosing
20. Have received treatment with a SARS-CoV-2-specific monoclonal antibody, remdesivir, 
or other treatment for COVID-19
21. Have received convalescent COVID-19 plasma treatment
22. Have participated in a previous SARS-CoV-2 vaccine study
23. Have participated, within the last 30 days, in a clinical study involving an investigational 
intervention. If the previous investigational intervention has a long half-life, 5 half-lives 
or 30 days, whichever is longer, should have passed.
24. Are concurrently enrolled in any other type of medical research judged not to be 
scientifically or medically compatible with this study
25. Are breast-feeding
26. Are investigator site personnel directly affiliated with this study
3.4.
Patient Group
There is 1 study population: participants treated with bamlanivimab.
3.5.
Endpoints
The study endpoints are defined as at 29, 60, and 90 days of the date of the bamlanivimab 
infusion. 
Figure 3.2.
Illustration of the timeline for study participants.
The following endpoints are defined based on the EDC and EMR data.

Primary endpoint:
o
COVID-19-related hospitalization (defined as ≥24 hours of acute care for 
COVID-19) or all-cause death up to 29, 60, and 90 days

Secondary endpoints:
o
COVID-19-related hospitalization, defined as ≥24 hours of acute care, up to 29, 
60, and 90 days
o
COVID-19-related emergency department (ED) visits up to 29, 60, and 90 days
o
Adverse Events (AEs) or Severe Adverse Events (SAEs) up to 2 hours, 24 hours, 
and 29, 60, and 90 days
The period of follow-up for ascertainment of these endpoints will be 29, 60, and 90 days 
following the infusion date. The COVID-19-related hospitalization or all-cause death will be 
Date of 
symptoms 
onset  
29 Days  
60 Days  
90 Days  
Look back  
Within 10 days  
Date of infusion 
treatment for study
participants
Date of COVID + 
(i.e. COVID 
diagnosis)
29 Days
60 Days
90 Days


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
15
LY3819253
defined as binary, and secondarily time to event variable will also be included. For time-to-event 
endpoints, days to the first COVID-19-related hospitalization or death will be calculated from the 
infusion date. For patients who do not experience a particular endpoint up to 29, 60, and 90 days 
following the infusion date, a censoring date will be defined as the earliest of 

29, 60, and 90 days following the infusion date, or

the early discontinuation date (study participants).
The AEs or SAEs will be collected from the CRF. The proportion of patients with an SAE or AE
will be reported. 
3.6.
Study Therapies
Bamlanivimab (LY3819253) is a neutralizing IgG1 monoclonal antibody to the spike protein of 
SARS-CoV-2. It is designed to block viral attachment and entry into human cells, thus 
neutralizing the virus, potentially preventing and treating COVID-19.
3.7.
Variables/Measures
The following variables will be defined based on the EDC/EMR data.
Table 3.1
Variable Definitions/Data Source
Variables
Definition
Data Source
Demographics
Age at index date, year
Age: whole numbers calculated from bamlanivimab 
index date
Age group: Age ≥65; Age 55 to 64; 
Age 18 to 54; and Age 12 to 17
From EMR
Sex
Female and male
From EMR
Race
American Indian / Alaskan Native
Asian
Black / African American
Native Hawaiian / Pacific Islander
White
Multiple
Ethnicity
Hispanic, non-Hispanic
Weight, kg
Continuous variable
Height, cm
Continuous variable
BMI
Calculated as BMI = kg/m2 where kg is a person's 
weight in kilograms and m2 is their height in meters
squared.
Continuous and categorical ≤25; 25 to <30; and ≥30
Tobacco use
current use, former, and never 
Vital signs

body temperature

pulse rate

systolic blood pressure

diastolic blood pressure

respiratory rate

SpO2
From EMR


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
16
LY3819253
Variables
Definition
Data Source

supplemental oxygen flow rate

FiO2 and method of delivery, if applicable
COVID-19 symptoms
Total of 8-binary indicator variables will be created 
for the below symptoms:

fever

cough

sore throat

malaise

chills

loss of sense of taste

loss of sense of smell

fatigue.

headache

muscle pain

gastrointestinal symptoms

shortness of breath with exertion
The date of COVID-19 symptom onset is defined as 
the earliest start date of symptoms suggestive of
SARS-CoV-2 infection; calculated by difference of 
bamlanivimab index date and reported symptom date
From EMR 
Days since COVID-19 
symptom onset.
Calculated as the difference index date and COVID-
19 symptom onset date.
Category: ≤8 days and >8 days
Type of COVID-19 
diagnosis test
RT-PCR, antigen testing
COVID-19 diagnosis date
Preexisting conditions 
and medical history
during 1 year prior to the 
infusion
Binary indicator variables will be created for the 
below:

chronic kidney disease

diabetes (type I, type II)

immunosuppressive disease

currently receiving immunosuppressive
treatment 

cardiovascular disease

hypertension

chronic obstructive pulmonary disease or other 
chronic respiratory disease

sickle cell disease

congenital or acquired heart disease

neurodevelopmental disorders

medical-related technological dependence; for 
example, tracheostomy, gastrostomy, or positive 
pressure ventilation (not related to COVID-19)

asthma, reactive airway or other chronic 
respiratory disease that requires daily medication 
for controls
From EMR 


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
17
LY3819253
Variables
Definition
Data Source
Treatments of special 
interest prescribed
within 30 days prior to 
infusion (exclusive 
infusion date)
Dates of:

NSAIDs

antivirals

antibiotics

anti-malarials

corticosteroids

immunomodulators

other investigational treatments (including
ivermectin, COVID-19 vaccine, and oxygen)
From EMR
Prior or concomitant
therapy 90 days before 
and 90 days after 
infusion 
Dates of:

NSAIDs

antivirals

antibiotics

anti-malarials

corticosteroids

immunomodulators
From EMR
Procedures of special 
interest during 10 days
prior infusion
Dates of:

supplemental oxygen

non-invasive ventilation

high flow oxygen device

mechanical ventilation

Extracorporeal membrane oxygenation (ECMO)

additional organ support
From EMR
Respiratory support
Dates of:

high flow nasal cannula

noninvasive positive pressure ventilation
From EMR
Mortality

date

cause of death
From EMR
Pregnancy
Date of confirmed pregnancy
From EMR
Abbreviations: BMI = body mass index; COVID-19 = coronavirus disease 2019; EMR = electronic medical record; 
FiO2 = fraction of inspired oxygen in the air; NSAID = nonsteroidal anti-inflammatory drug; RT-PCR = reverse 
transcription-polymerase chain reaction; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2; SpO2 
= saturation of peripheral oxygen.


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
18
LY3819253
4.
Statistical Analyses
4.1.
General Considerations
All analyses will be conducted on bamlanivimab-treated study participants. 
Descriptive analysis will be conducted without imputation of missing values. Categorical 
variables will be summarized using frequencies and proportions. Continuous variables will be 
summarized using mean with standard deviations, and medians with interquartile range.  
Additional exploratory analyses of the data will be conducted as deemed appropriate.
All statistical analyses will be performed using SAS software Version 9.4 (or a higher version).
4.2.
Participant Dispositions 
The number and percentage of study participants who complete the study or discontinue early 
will be tabulated up to 29, 60, and 90 days follow-up. Reasons for discontinuation will be 
summarized.
4.3.
Populations for Analyses
The analysis population includes all patients who meet inclusion criteria and receive 
bamlanivimab in a single IV infusion of 700 mg or less.
4.4.
Primary Analyses and Methodology
To address the primary study objective, this section describes the primary analysis determining 
the rates of COVID-19-related hospitalization or death among bamlanivimab-treated patients.
Primary Efficacy Outcome Analysis: COVID-19-Related Hospitalization or all-cause Death 
up to Days 29, 60, and 90
The primary analysis will determine the number and proportions of the bamlanivimab-treated 
patients with a COVID-19-related hospitalization or all-cause death up to Days 29, 60, and 90
(binary outcome).
Ninety-five-percent confidence intervals (CIs) for hospitalization or all-cause death proportion at 
Days 29, 60, and 90 will be provided. The 95% CIs will be constructed using the asymptotic 
method without continuity correction (that is, normal approximation to the binomial 
distribution). 
Sensitivity Analyses for the Primary Objective
In addition to the above primary analysis, the following analyses maybe performed as sensitivity 
analyses.
Time to Event 
Time to the first COVID-19-related hospitalization or all-cause death at Days 29, 60, and 90 will 
be calculated as the duration from the infusion date to the first date of admission to COVID-19-
related hospitalization or death date (the duration = the first date of admission to COVID-19-
related hospitalization or death date plus - infusion date +1). For patients who do not experience 
a COVID-19-related hospitalization or death up to Day 29 (60, 90) following the infusion date, a 


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
19
LY3819253
censoring date is defined as the earliest of 29 (60, 90) days following the infusion date, or the 
early discontinuation date (such as due to lost to follow-up or drop out). For those who are not 
admitted due to COVID-19 or have not died up to Day 29 (60, 90), the outcome will be treated
as a censored response after Day 29 (60, 90). Cumulative incidence of COVID-19-related 
hospitalization or all-cause death at Days 29, 60, 90 will be estimated based on Kaplan-Meier 
estimates. Kaplan-Meier curves will also be plotted. The number of patients who experienced 
COVID-19-related hospitalization or die from any cause, cumulative incidence of each endpoint, 
95% CI of the cumulative incidence, and number of patients at risk over time will be reported at 
Days 29, 60, and 90.
4.5.
Secondary Analyses
To support the secondary study objectives, analyses will include:

determination of the proportions of patients with COVID-19-related hospitalizations up 
to Days 29, 60, and 90

COVID-19-related ER visits up to Days 29, 60, and 90

Description of AEs and SAEs up to 2 hours, 24 hours, Days 29, 60, and 90.
Descriptive analyses for these secondary objectives will follow the same statistical methodology 
as used for the primary analysis.
COVID-19-related ED visits, AEs, and SAEs defined in Section 3.5 will be summarized by 
numbers and percentage up to 2 hours, 24 hours, and 29, 60, and 90 days after infusion. A listing 
of AE data for patients at any time during the study will be provided, including age, gender, race, 
the description of AE, start date, stop date, time from infusion (in days), and severity.
Exposure to Therapy 
Exposure to therapy will be listed, including timing of infusion, planned dose, total dose 
administered, treatment interrupted, and reason for interruption. Exposure to therapy will be 
represented as the total number of complete and incomplete infusions and will be summarized 
using descriptive statistics.
Adverse Events
Although all AEs after signing the ICF are recorded by the site in the CRF/EDC, SAE reporting 
to the sponsor begins after the participant has signed the ICF and has received study intervention. 
However, if a SAE occurs after signing the ICF, but prior to receiving study intervention, it will 
be reported within the SAE reporting timeframe if it is considered reasonably possibly related to 
study procedures.
Adverse events will be coded according to the Medical Dictionary for Regulatory Activities
(MedDRA). Summaries of AEs will include the number of participants with at least 1 AE. When 
reporting by System Organ Class (SOC) and Preferred Term (PT), the reports will present the 
SOC in alphabetical order; PTs within the SOCs will be presented in order of decreasing 
frequency of occurrence overall. A patient with multiple AEs (different PTs) coded to the same 
SOC will be counted only once for that SOC but will be counted each time for different PTs 
within that SOC. A patient with separate events of the same PT will be counted only once in the 
frequency tables for that PT. 


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
20
LY3819253
The number and percentage of participants who experienced an AE, SAE, AE related to study 
drug, died due to an AE, discontinued from the study treatment, or discontinued from the study 
due to an AE will be summarized by during infusion and after infusion for up to 2 hours, 
24 hours, 29 days, 60 days, and 90 days. The summary method for each event type is described 
in Table 4.1. 
Table 4.1
Types of Adverse Events to be Summarized
Event Type
Summary Method
SAE
SAEs will be summarized for study participants by SOC and PT. These 
reports will also include the total number of SAE for each SOC and PT.
AE Resulting in Death
If there are any AEs that result in death, a listing of all deaths will be 
provided. In addition, a summary table may also be created by PT in order of 
decreasing frequency of PT.
AE Leading to Study Drug 
Discontinuation
AEs for which the action taken with medication as ‘Drug Withdrawal’ will 
be identified as AEs that lead to study drug discontinuation. The AEs that 
lead to study drug discontinuation will be summarized by SOC and PT for 
the safety population. A by-patient listing of the AEs that lead to study drug 
discontinuation will also be provided.
Treatment-Related AE
Every AE will be assessed by the investigator for its relationship to the study 
treatment.
AE by Maximal Severity
Every AE will be graded by the investigator as mild, moderate, or severe, so 
for each patient the greatest severity observed can be obtained by comparing 
the severity of all of a patient’s AEs that share the same SOC or PT. A table 
of AEs by maximal severity will be prepared by SOC and PT.
AE (Not Including Serious) 
The most common, nonserious AEs will be summarized. All PTs that occur 
in at least 1% of the safety population participants, when not counting the 
serious AEs, will be tabulated by SOC and PT. These reports will also 
present the total number of AEs for each SOC and PT.
Abbreviations: AE = adverse event; PT = Preferred Term; SAE = serious adverse event; 
SOC = System Organ Class.
Infusion Site Reactions
Infusion site reactions are AEs localized to the immediate site of the administration of a drug and
will be defined using terms from the MedDRA High-Level Term, Infusion Site Reactions. All 
ISRs will be listed. 
The number and percentage of patients with AEs related to infusion sites, SAEs related to 
infusion sites, and AEs related to infusion sites resulting in study drug discontinuation will be 
summarized using MedDRA PT. Events will be ordered by decreasing frequency.
The number and percentage of patients with AEs related to infusion sites by maximum severity 
will be summarized using MedDRA PT.
Hypersensitivity, Anaphylactic, and Infusion-Related Reactions
Hypersensitivity reactions is used as an overarching term to describe events that are systemic or 
localized reactions that likely have an allergic/hypersensitivity etiology. At all visits in Phase 3 
clinical studies, patients will be evaluated by the investigator for signs and symptoms suggestive 
of hypersensitivity. Investigators will complete a CRF designed to record additional information 
about AEs suggestive of a hypersensitivity reaction.


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
21
LY3819253
Two main analyses are performed respectively assessing (a) potential immediate 
hypersensitivity, including anaphylaxis and IRRs, and (b) potential nonimmediate 
hypersensitivity.
Time Period A, of potential immediate hypersensitivity, includes all AEs occurring on the day 
of study drug administration.
Time Period B, of potential nonimmediate hypersensitivity, includes all AEs occurring strictly 
after the day of study drug administration.
Analyses for both time periods are based on the following Standard MedDRA Queries (SMQs):

Anaphylactic reaction SMQ (20000021; narrow and broad)

Hypersensitivity SMQ (20000214; narrow and broad), and

Angioedema SMQ (20000024; narrow and broad).
Additionally, for the Anaphylactic reaction SMQ in Time Period A, the algorithmic query (per 
the MedDRA Maintenance and Support Services Organization [MSSO] SMQ guide) will be 
performed. An algorithmic case must include either

a narrow term from the SMQ (Category A of the SMQ), or

multiple terms from the SMQ comprising terms from at least 2 of the following 
categories from the SMQ
o
Category B - (Upper Airway/Respiratory)
o
Category C - (Angioedema/Urticaria/Pruritus/Flush), or
o
Category D - (Cardiovascular/Hypotension).
Where algorithm is mentioned below, this applies only to Time Period A.
The number and percentage of patients reported with an AE for the following will be analyzed 
for each of the 2 time periods:

any narrow or algorithmic term from any 1 of the 3 SMQs indicated above (that is, 
combined search across narrow and algorithmic portions of all 3 SMQs)

any narrow term within each SMQ, separately (that is, narrow SMQ search), and

any term within each SMQ, separately (that is, broad SMQ search).
Within queries, individual PTs that satisfied the queries will be summarized.
For Time Period A only, the number and percentage of each PT that is not in any of the 3 SMQs 
(that is, other events occurring on the day of study drug administration) will be summarized 
overall and by individual PT. Only PTs that occur in at least 3 patients receiving bamlanivimab 
will be displayed in this portion of the table.
The PTs will be arranged in the summary in decreasing order of frequency for patients in the 
total bamlanivimab treatment group. Note that an individual patient may contribute multiple 
events. Also, a single event may satisfy multiple SMQs, in which case the event contributes to 
every applicable SMQ.


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
22
LY3819253
The analyses above are the starting point for medical interpretation of any apparent differences 
between treatment groups. For notable events, case review will be applied to make the final 
determination of whether an event is most accurately described as a potential hypersensitivity 
reaction to a drug or another event that is not clearly associated with drug administration. This 
judgment will be on the basis of totality of information available, including the content of the 
follow-up CRF collected for potential hypersensitivity events.
Vital Signs and Other Physical Findings
The measurements analyzed for vital signs and physical characteristics include systolic blood 
pressure (BP), diastolic BP, pulse, peripheral oxygen saturation, respiratory rate, and 
temperature, if data warrant. 
Given different total volumes of solution for administration of 700mg bamlanivimab (200ml, 
100ml, and other volume which will be entered in the CRF by site), the infusion duration will 
differ, such as about 1 hour for the total amount of 200 ml, and about 30 minutes for the total 
amount of 100 ml. For this reason, vital signs will be summarized at the following timepoints: 
baseline, half infusion, end of infusion, 30 minutes post-infusion, and 1 hour post-infusion, rather 
than using the recommended timing (immediately before the infusion, every 15 minutes during 
the infusion, and every 30 minutes for at least 1 hour after the infusion). Baseline is defined as 
the last non-missing value before patient’s bamlanivimab infusion.  
Vital signs data will be summarized by box plots for observed values, along with changes from 
baseline by timepoints.
Box plots for observed values by timepoints will include participants with a non-missing value at 
the timepoint. Values outside 1.5 interquartile range (IQR) below 25% and above 75% will be 
shown as outliers. Descriptive summary statistics will be included in a table below the box plot.
Box plots for change from baseline values to each post baseline timepoints will be presented 
similarly to those for observed values by timepoints described above. They will include 
participants with a non-missing value at the timepoint, and values outside 1.5 IQR below 25% 
and above 75% will be shown as outliers. Descriptive summary statistics will be included in a 
table below the box plot.
All vital signs and other physical findings for individual participants will be listed.
Protocol Violations
Protocol violations will be identified throughout the study. Important protocol deviations (IPDs)
are defined as those deviations from the protocol that would potentially compromise participants’ 
safety, data integrity, or study outcome. 
The number and percentage of participants having IPDs will be summarized within each 
category and subcategory of deviations. A by-patient listing of IPDs will be provided.
4.6.
Handling of Missing Data or Dropouts
Due to low study enrollment, all objectives are descriptive in nature. Summary statistics will be 
based on nonmissing data.  


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
23
LY3819253
4.7.
Other Analyses
The total number of bamlanivimab-treated participants is 109. No subgroup analyses will be 
conducted.
4.8.
Interim Analyses
Not applicable. 
4.9.
Changes to Protocol-Planned Analyses
Since enrollment was determined to be infeasible, and the total number of bamlanivimab-treated 
participants is 109, analyses using a control group and propensity score matching are not 
feasible. The study is underpowered for the comparative analyses that were originally planned 
and described in the protocol and Version 1 of the SAP, and any results from such comparative 
analyses would be uninterpretable and lack scientific rigor. For this reason, the decision was 
made to change the protocol-planned comparative analyses to descriptive noncomparative 
analyses.


CONFIDENTIAL
Protocol number J2X-MC-PYAJ SAP v3
24
LY3819253
5.
References
[FDA] United States Food and Drug Administration. COVID-19: developing biological products 
for treatment or prevention: guidance for industry. Published May 2020. 
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/covid19-
developing-drugs-and-biological-products-treatment-or-prevention.
[FDA] Assessing COVID-19-Related Symptoms in Outpatient Adult and Adolescent Subjects in 
Clinical Trials of Drugs and Biological Products for COVID-19 Prevention or Treatment: 
Guidance for Industry. Issued September 2020. https://www.fda.gov/media/142143/download.
[FDA] United States Food and Drug Administration. Fact sheet for health care providers 
emergency use authorization (EUA) of bamlanivimab. Revised December 2020. Accessed 
January 19, 2021. https://www.fda.gov/media/143603/download.


Leo Document ID = 7b5f99bf-f3d5-492f-b738-42248c5c617d
Approver: 
Approval Date & Time: 13-Aug-2021 14:53:23 GMT
Signature meaning: Approved
PPD