Nirmatrelvir, Molnupiravir Use Lowers Risks for Omicron-Infected

MONDAY, Sept. 25, 2023 (HealthDay News) -- For patients infected with omicron at high risk for progression to severe disease, treatment with nirmatrelvir or molnupiravir is associated with reductions in mortality and hospitalization, according to a study published online Sept. 21 in JAMA Network Open.

Dan-Yu Lin, Ph.D., from the University of North Carolina in Chapel Hill, and colleagues examined the association of nirmatrelvir or molnupiravir use with the risks for hospitalization and death among patients infected with new omicron subvariants in a cohort study of patients who received a diagnosis of COVID-19 from April 1, 2022, to Feb. 20, 2023, and who had a high risk for progression to severe disease. During this time, the omicron variant evolved from BA.2 to BA.4/BA.5, then to BQ.1/BQ.1.1, and finally to XBB/XBB.1.5.

Data were included for 68,867 patients: 22,594 treated with nirmatrelvir, 5,311 treated with molnupiravir, and 40,962 who received no treatment. The researchers found that 30, 27, and 588 patients treated with nirmatrelvir, treated with molnupiravir, and who received no treatment, respectively, died within 90 days of omicron infection. The adjusted hazard ratios for death were 0.16 and 0.23 for nirmatrelvir and molnupiravir, respectively. The corresponding adjusted hazard ratios for hospitalization or death were 0.63 and 0.59. Across subgroups defined by age, race and ethnicity, date of COVID-19 diagnosis, vaccination status, previous infection status, and coexisting conditions, the association of both drugs with both conditions were observed.

"Both drugs can, therefore, be used to treat nonhospitalized patients who are at high risk of progressing to severe COVID-19," the authors write.

Several authors disclosed ties to the biopharmaceutical and publishing industries.

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