JAMA Netw Open

Nirmatrelvir/ritonavir vs. molnupiravir: How do they stack up against Omicron?

September 26, 2023

Both ritonavir-boosted nirmatrelvir and molnupiravir worked similarly well at preventing death and hospitalization in patients infected with the Omicron strain.

• The Cleveland Clinic-based observational cohort study included 68,867 patients diagnosed with COVID-19 (42.7% aged 65 and over; 38.9% male; 74.7% non-Hispanic White).
• Thirty of the 22,594 patients treated with nirmatrelvir, 27 of 5,311 patients treated with molnupiravir, and 588 of 40,962 patients who received no treatment died within 90 days of Omicron infection. Adjusted hazard ratios (HRs) of death were 0.16 (95% confidence interval [CI], 0.11-0.23) for nirmatrelvir and 0.23 (95% CI, 0.16-0.34) for molnupiravir. Adjusted HRs of hospitalization or death were 0.63 (95% CI, 0.59-0.68) for nirmatrelvir and 0.59 (95% CI, 0.53-0.66) for molnupiravir. 
• The associations of both drugs with both outcomes were observed across subgroups defined by age, race and ethnicity, date of COVID-19 diagnosis, vaccination status, previous infection status, and coexisting conditions.
• Authors conclude that both drugs can be used to treat nonhospitalized patients who are at high risk of progression to severe COVID-19.

Source:

Lin DY. JAMA Netw Open. (2023, Sep 5). Nirmatrelvir or Molnupiravir Use and Severe Outcomes From Omicron Infections. https://pubmed.ncbi.nlm.nih.gov/37733342/