Scientists from McMaster University found the antiviral drugs molnupiravir and nirmatrelvir–ritonavir (Paxlovid), when used to treat nonsevere COVID-19, most likely reduce the risk of subsequent progression to hospitalization and death.
The research is published in CMAJ (Canadian Medical Association Journal) and was conducted by Dr. Tyler Pitre et al.
In the study, the team reviewed the effectiveness of these drugs in treating non-severe COVID-19.
They identified 41 trials involving 18,568 patients with non-severe COVID-19, most of whom were aged 36.5 to 65.5 years.
Compared with standard care, nirmatrelvir–ritonavir likely reduced the risk of hospital admission and molnupiravir probably reduced the risk.
These findings suggest that nirmatrelvir–ritonavir may be superior to molnupiravir for some outcomes.
The study has implications for organizations, such as the [World Health Organization] WHO, that are in the process of developing recommendations addressing molnupiravir and nirmatrelvir–ritonavir.
The team says health care systems deciding on drug procurement and cost issues need to consider the relative efficacy of nirmatrelvir–ritonavir over molnupiravir.
In a related commentary, researchers point out challenges in applying these findings to current patients with COVID-19.
Several of the trials on which the study is based were conducted among unvaccinated patients who had been infected with the Delta variant.
As a big portion of Canada’s population is now vaccinated and many have been infected with the Omicron variant, the medications may be less effective in a real-world setting.
The commentary authors call for national and international approaches to rapidly generate evidence in a changing disease landscape.
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