COVID-19 · Antivirals in outpatients
Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19
| Design | Phase 2-3, randomised, double-blind, placebo-controlled trial |
|---|---|
| Treatment | Oral nirmatrelvir plus ritonavir |
| Control | Placebo |
| Population | 2246 unvaccinated non-hospitalised adults with symptomatic COVID-19 and at least one risk factor for progression |
| Follow-up | 28 days |
| Primary endpoint | COVID-19-related hospitalisation or death from any cause by day 28 |
| Result | Among patients treated within 3 days of symptom onset, the risk of progression to severe COVID-19 was 89% lower with nirmatrelvir-ritonavir than with placebo, without evident safety concerns. |
| Secondary endpoints | Viral load, symptom duration, safety |
Treatment of symptomatic Covid-19 with nirmatrelvir plus ritonavir resulted in a risk of progression to severe Covid-19 that was 89% lower than the risk with placebo, without evident safety concerns.
The trial authors, in the published abstract
A spectacular effect size in a population that no longer exists in most countries: unvaccinated, previously uninfected, high-risk adults facing an earlier variant. Later trials in vaccinated populations found far less, which is the necessary context for anyone quoting the 89%.
Hammond J, Leister-Tebbe H, Gardner A, et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med 2022 Apr 14;386(15):1397-1408.