n/2
— SP Kalantri (@spkalantri) December 28, 2022
Early trials in COVID-19 participants with nirmatrelvir–ritonavir suggested that participants were 89% less likely to be hospitalised or die (compared with placebo).
n/4
— SP Kalantri (@spkalantri) December 28, 2022
“I am triple vaccinated and aged 55. My baseline risk of hospitalisation or death is 1%. I wish to lower the risk. Will Molnupiravir benefit me, if I swallow the pills within three days of infection?”
n/6
— SP Kalantri (@spkalantri) December 28, 2022
The trial enrolled 25 708 participants and compared Molnupiravir + usual care with usual care alone as an early treatment for community-based adults with COVID-19 at higher—but not highest—risk of adverse outcomes.
n/8
— SP Kalantri (@spkalantri) December 28, 2022
What did the study show?
105 (1%) of 12 529 people in the molnupiravir + usual care group and 98 (1%) of 12 525 in the usual care group were hospitalised or died. This was the baseline risk: 1 in 100 chance of hospitalisation or death.
n/10
— SP Kalantri (@spkalantri) December 28, 2022
This is an important fact. Vaccination has benefitted high risk people. Even when they are infected with the omicron variant, their chances of hospitalisation or dying is low. When the baseline risk is lower, most drugs are unable to reduce it further.
n/12
— SP Kalantri (@spkalantri) December 28, 2022
So, what next. Let the treatments we design be data-driven. Favipiravir failed. So did Molnupiravir. Negative trials are as important as the positive ones. They teach us what doesn’t work.
Time to move on.
END