According to studies, Paxlovid reduces hospitalization due to COVID-19, the risk of death and accelerates symptom relief

New evidence from two studies has found that use of the antiviral drug nirmatrelvir-ritonavir (Paxlovid) leads to a reduction in hospitalizations and deaths due to COVID-19, as well as faster resolution of symptoms and less use of healthcare resources.

The benefit is only observed in older patients

For the first time studypublished in Clinical microbiology and infectionA research team led by the Medical University of Vienna compared the effectiveness of paxlovid with that of the antiviral drug molnupiravir (Lagevrio) – and with the effectiveness of not receiving an antiviral drug – against hospitalizations and deaths from all causes from January 2022 to May 2023. Participants were adults with mild to moderate infections and one or more risk factors for severe disease caused by the SARS-CoV-2 Omicron variant.

“The oral antiviral drugs nirmatrelvir-ritonavir and molnupiravir are the main treatment for Covid-19 in non-hospitalized adults at increased risk of severe disease,” the study authors wrote. “Both oral antiviral medications were approved for the treatment of non-hospitalized patients with mild to moderate Covid-19 disease at the time of the study period (2022/2023), but current National Institutes of Health guidelines favor nirmatrelvir-ritonavir over molnupiravir.” .”

Of the 113,399 eligible COVID-19 patients in the retrospective cohort study, 10.7% received paxlovid, 9.5% received molnupiravir, and 80.0% served as untreated controls. Over 96% of participants were previously infected with COVID-19 or vaccinated against COVID-19.

Future studies are needed to better define the target groups that will derive greater benefit from nirmatrelvir-ritonavir treatment.

A total of 0.43% of paxlovid recipients, 1.4% of molnupiravir users and 1.13% of controls were hospitalized within 28 days (risk difference). [RD]-0.7%; Paxlovid vs. control RD, 0.26%. No paxlovid recipients died and 0.13% each of molnupiravir users and controls died.

The estimated risk of hospitalization was 0.57% in paxlovid users and 1.09% in controls (adjusted RD). [aRD]-0.53%). The estimated risk of death was 0.0% in the paxlovid group and 0.13% in the control group (aRD, -0.13%).

The number of patients who required treatment to prevent hospitalization and death was 190 among paxlovid recipients and 792 among controls, respectively. These statistically significant aRDs were only observed in patients aged 60 years and older.

The estimated risk of hospitalization in the molnupiravir analysis was 1.36% in the molnupiravir group and 1.16% in the control group (aRD, 0.2%). The estimated risk of death was 0.12% in molnupiravir recipients and 0.14% in controls (aRD, -0.01%).

“Among outpatients aged ≥ 60 years with Covid-19 in an Omicron-dominated era, treatment with nirmatrelvir-ritonavir was associated with a lower risk of hospitalization and all-cause death within 28 days, albeit with wide confidence intervals and high numbers treat,” the study authors wrote.

“This finding was not observed in molnupiravir users and younger nirmatrelvir-ritonavir users. Future studies are needed to better define target populations that will show greater benefit from nirmatrelvir-ritonavir treatment,” they concluded.

Proportion of patients seeking treatment decreased by 73%

The second studya phase 2/3 randomized clinical trial published today Clinical infectious diseasesalso found protection against COVID-19 hospitalizations and deaths in adults who received paxlovid, and showed faster improvement in symptoms and lower use of healthcare resources compared to a placebo in high-risk patients.

The importance of effective COVID-19 treatments such as NMV/r [Paxlovid] Reducing the burden on healthcare systems, both outpatient and hospital, should not be underestimated.

The research was led by researchers at Pfizer, which developed Paxlovid. The drug was administered to 977 symptomatic COVID-19 patients at 343 sites in 21 countries from July 2021 to December 2021, a Delta-dominant period, while 989 received a placebo.

Paxlovid significantly shortened the time to symptom relief (median 13 vs. 15 days; hazard ratio). [HR]1.27) and resolution (16 vs. 19 days; HR, 1.20) over 28 days and reduced the number of COVID-related medical visits by 64.3% and the proportion of patients seeking care by 73.2 %.

Overall, 0.9% of paxlovid recipients and 6.4% in the placebo group were hospitalized, representing a relative risk reduction of 85.5%. Patients hospitalized with Paxlovid had shorter hospital stays and none required intensive care or mechanical ventilation. Fewer patients in the paxlovid group required other COVID-19 treatments and none died within 6 months, compared to 15 in the placebo group.

“The importance of effective COVID-19 treatments such as NMV/r [Paxlovid] Efforts to reduce the burden on healthcare systems, both outpatient and hospital, should not be underestimated,” the authors write.