A LARGE-scale trial has recently demonstrated the efficacy of nirmatrelvir/ritonavir (NMV/r), an oral antiviral, in reducing hospitalisations, symptom duration, and healthcare resource utilisation in high-risk, unvaccinated adults with mild-to-moderate COVID-19.
The Phase II/III double-blind, randomised study was conducted across 343 sites in 21 countries. Between July–December 2021, the team enrolled 2,113 symptomatic, non-hospitalised adults who did not receive monoclonal antibodies and had symptom onset ≤5 days. A pre-specified analysis population of 1,966 patients (977 receiving NMV/r and 989 placebo) was used to assess outcomes.
Patients treated with NMV/r (300 mg/100 mg every 12 hours for 5 days) achieved faster symptom alleviation (median: 13 days versus 15 days; hazard ratio [HR]: 1.27, P<0.0001) and resolution (16 days versus 19 days; HR: 1.20, P=0.0022) compared to placebo. Hospitalised patients receiving NMV/r had shorter stays, with no intensive care unit admissions or mechanical ventilation required, and all were discharged to home or self-care.
Importantly, none of the NMV/r-treated patients died through 24 weeks of follow-up, while 15 deaths occurred in the placebo group. NMV/r also significantly reduced the need for COVID-19-related medical visits and additional treatment compared to placebo.
This study reinforces NMV/r’s potential as an effective treatment for high-risk patients, offering benefits beyond reducing hospitalisations and mortality. The shorter symptom duration, fewer medical visits, and reduced need for subsequent treatments highlight its role in alleviating healthcare burdens.
Clinicians managing unvaccinated or high-risk populations should consider NMV/r as a critical option to mitigate severe outcomes and improve recovery timelines for COVID-19 patients.
Reference
Hammond J et al. Alleviation of COVID-19 symptoms and reduction in healthcare utilization among high-risk patients treated with nirmatrelvir/ritonavir (NMV/r): a phase 3 randomized trial. Clin Infect Dis. 2024; DOI:10.1093/cid/ciae551.
