Nirmatrelvir and ritonavir combo cuts COVID-19 risks for high-vulnerability groups

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Nirmatrelvir and ritonavir combo cuts COVID-19 risks for high-vulnerability groups
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itemprop=description content=Nirmatrelvir and ritonavir treatment significantly reduces the risk of hospitalization and death from COVID-19 in high-risk individuals, according to a recent JAMA Network Open study. However, the treatment's efficacy varied based on the degree of vulnerability, emphasizing tailored approaches for different risk groups.

By Dr. Priyom Bose, Ph.D.Oct 8 2023Reviewed by Benedette Cuffari, M.Sc. The ongoing coronavirus disease 2019 pandemic, caused by the rapid outbreak of the severe acute respiratory syndrome coronavirus 2 , has immensely affected the global healthcare system and economy.

Background Nirmatrelvir and ritonavir, collectively known as Paxlovid, is an oral anti-viral combination used to treat SARS-CoV-2 infection. The United States Food and Drug Administration approved the use of nirmatrelvir and ritonavir based on efficacy and safety data obtained during the Evaluation of Inhibition for COVID-19 in High-Risk Patients trial, which was conducted prior to the emergence of the SARS-CoV-2 Omicron variant.

Multiple studies across variable populations have indicated a protective function of nirmatrelvir and ritonavir therapy against SARS-CoV-2 infection. Nevertheless, it is essential to assess the benefit-harm profile of this treatment. Four mutually exclusive population groups were formed that included highly vulnerable participants at high risk of severe SARS-CoV-2 infection and were eligible for nirmatrelvir and ritonavir drugs within the study period. These included clinically extremely vulnerable people, including severely or moderately immunocompromised .

Study findings A total of 6,866 participants were included in this study, 56.6% female with a median age of 79. Nirmatrelvir and ritonavir-treated patients were matched by age and sex in all four groups. The vaccination rate was over 90% in all three CEV groups and less than 80% in the EXEL group. However, a similar association was not observed in individuals at a lower risk of complications in the EXEL group. This observation was true irrespective of sex and age.

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