September 26, 2023
2 min read
Source/Disclosures
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Disclosures:
Butt reports receiving investigator-initiated grant funding from Gilead Sciences and Merck & Co paid to the Veterans Health Foundation of Pittsburgh. All other authors report no relevant financial disclosures.
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Key takeaways:
- Paxlovid was associated with a significant reduction in 30-day hospitalization or death.
- Differences in these outcomes was significant depending on age and symptoms, and regardless of vaccination status.
Nirmatrelvir/ritonavir, or Paxlovid, was associated with a significant reduction in 30-day hospitalization or death among previously uninfected patients with COVID-19 who were not hospitalized, researchers found.
“We have a large number of drugs proposed as treatment for COVID-19. Relatively few drugs have been evaluated in well-designed randomized clinical trials (RCTs). Nirmatrelvir has been evaluated in well-designed RCTS. However, RCTs are highly controlled experiments, and we need to evaluate and demonstrate the effectiveness of these agents in the real-world settings, which are more reflective of what our actual patients experience,” Adeel Ajwad Butt, MBBS, MS, FACP, FIDSA, professor of medicine and professor of population health sciences at Weill Cornell Medical College and director of research in quality and senior consultant at the Hamad Medical Corporation, told Healio.
Treating patients with Paxlovid within 3 days of COVID-19 diagnosis was associated with a significant reduction in hospitalization or death. Image: Adobe Stock.
“Our motivation to do this study was to evaluate the effectiveness of nirmatrelvir in a real-world scenario and to see if it mirrors the results of the RCTs,” he said.
Butt and colleagues conducted a study using a matched cohort design of inverse probability of treatment weight (IPTW) including variables such as age, race, sex, BMI, geographic location, vaccination status and multiple comorbidities.
According to the study, patients prescribed nirmatrelvir/ritonavir (NMV/r), or Paxlovid, within 3 days of COVID-19 diagnosis were compared with IPTW-based untreated controls.
In total, 7,615 patients were prescribed NMV/r between Jan. 1, 2022, and Feb. 25, 2023, whereas 62,077 patients acted as controls. Overall, they found that that the risk of hospitalization and/or death was lower among NMV/r treated vs. untreated controls (243 vs. 3,468 events; absolute risk difference [ARD] = 2.36; 95% CI, 2.57 to 2.14).
The researchers also found significant differences based on age and symptoms. According to the study, the differences were significant between patients aged older than 60 and those aged 60 and younger (ARD = 3.86; 95% CI, 4.19 to 3.54 vs. ARD = 0.27; 95% CI, 0.51 to 0.03), as well as for those who were asymptomatic vs. symptomatic (ARD = 7.09; 95% CI, 7.62 to 6.55 vs. ARD = 1.46; 95% CI, 1.66 to 1.25).
The study also demonstrated that there was significant benefit observed among patients who were unvaccinated (ARD = 2.5; 95% CI, 2.92 to 2.07), and vaccinated, with a booster dose (ARD = 2.56; 95% CI, 2.87 to 2.25) or without (ARD = 1.83; 95% CI, 2.25 to 1.42).
Based on these findings, Butt concluded that “NMV/r is associated with a significant reduction in 30-day hospitalization or death among previously uninfected, non-hospitalized individuals.”
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