tetano
Editor, Senior Moderator
Clin Microbiol Infect
. 2022 May 8;S1198-743X(22)00223-3.
doi: 10.1016/j.cmi.2022.04.015. Online ahead of print.
First-generation Oral Antivirals Against SARS-CoV-2
Parham Sendi[SUP] 1 [/SUP], Raymund R Razonable[SUP] 2 [/SUP], Sandra B Nelson[SUP] 3 [/SUP], Alex Soriano[SUP] 4 [/SUP], Rajesh Tim Gandhi[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Oral drugs against SARS-COV-2 have received emergency use authorization for the treatment of mild-to-moderate COVID-19 in nonhospitalized patients who are at high risk for clinical progression.
Objectives: To provide a clinical practice overview of first-generation oral antiviral agents against SARS-CoV-2.
Sources: References for this review were identified through searches of PubMed, Google Scholar, bioRxiv, medRxiv, regulatory drug agencies, and pharmaceutical companies' websites up to 16 February 2022.
Content: Molnupiravir and nirmatrelvir/ritonavir have been authorized for use in nonhospitalized individuals with mild-to-moderate COVID-19 who are at high risk for progression. In clinical trials, molnupiravir reduced the frequency of hospitalization or death by 3% (relative risk reduction 30%), and nirmatrelvir/ritonavir by 6% (relative risk reduction 89%). Their use in clinical practice requires early administration, review of drug-drug interactions (nirmatrelvir/ritonavir), considerations of embryo-fetal toxicity (molnupiravir), and compliance with ingestion of a high number of pills. Knowledge gaps include the efficacy of these agents in vaccinated, hospitalized, or immunosuppressed individuals with prolonged SARS-CoV-2 persistence.
Implications: First-generation oral antivirals represent progress in therapeutics against SARS-CoV-2, but also pose new challenges in clinical practice. Further advances in the development of new drugs are required.
Keywords: Antivirals; COVID-19; Coronavirus; Molnupiravir; Nirmatrelvir; SARS-CoV-2.
. 2022 May 8;S1198-743X(22)00223-3.
doi: 10.1016/j.cmi.2022.04.015. Online ahead of print.
First-generation Oral Antivirals Against SARS-CoV-2
Parham Sendi[SUP] 1 [/SUP], Raymund R Razonable[SUP] 2 [/SUP], Sandra B Nelson[SUP] 3 [/SUP], Alex Soriano[SUP] 4 [/SUP], Rajesh Tim Gandhi[SUP] 3 [/SUP]
Affiliations
- PMID: 35545195
- DOI: 10.1016/j.cmi.2022.04.015
Abstract
Background: Oral drugs against SARS-COV-2 have received emergency use authorization for the treatment of mild-to-moderate COVID-19 in nonhospitalized patients who are at high risk for clinical progression.
Objectives: To provide a clinical practice overview of first-generation oral antiviral agents against SARS-CoV-2.
Sources: References for this review were identified through searches of PubMed, Google Scholar, bioRxiv, medRxiv, regulatory drug agencies, and pharmaceutical companies' websites up to 16 February 2022.
Content: Molnupiravir and nirmatrelvir/ritonavir have been authorized for use in nonhospitalized individuals with mild-to-moderate COVID-19 who are at high risk for progression. In clinical trials, molnupiravir reduced the frequency of hospitalization or death by 3% (relative risk reduction 30%), and nirmatrelvir/ritonavir by 6% (relative risk reduction 89%). Their use in clinical practice requires early administration, review of drug-drug interactions (nirmatrelvir/ritonavir), considerations of embryo-fetal toxicity (molnupiravir), and compliance with ingestion of a high number of pills. Knowledge gaps include the efficacy of these agents in vaccinated, hospitalized, or immunosuppressed individuals with prolonged SARS-CoV-2 persistence.
Implications: First-generation oral antivirals represent progress in therapeutics against SARS-CoV-2, but also pose new challenges in clinical practice. Further advances in the development of new drugs are required.
Keywords: Antivirals; COVID-19; Coronavirus; Molnupiravir; Nirmatrelvir; SARS-CoV-2.