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Clin Ther . Hospitalization Among Patients Treated With Molnupiravir: A Retrospective Study of Administrative Data

tetano

Editor, Senior Moderator
Clin Ther


. 2023 Aug 17;S0149-2918(23)00290-4.
doi: 10.1016/j.clinthera.2023.07.018. Online ahead of print. Hospitalization Among Patients Treated With Molnupiravir: A Retrospective Study of Administrative Data

Girish Prajapati[SUP] 1 [/SUP], Amar Das[SUP] 2 [/SUP], Yezhou Sun[SUP] 2 [/SUP], Eileen Fonseca[SUP] 2 [/SUP]



Affiliations
Abstract

Purpose: Molnupiravir is an oral antiviral agent authorized for emergency use to treat mild to moderate cases of coronavirus disease 2019 (COVID-19) in adults at high risk for progression to severe clinical outcomes. This study aimed to describe patient characteristics and health outcomes in a cohort of adult patients treated with molnupiravir in an outpatient setting in the United States.
Methods: This was a retrospective cohort study of adults identified in the HealthVerity database with a pharmacy claim for molnupiravir between December 24, 2021, and April 14, 2022. Hospitalization and health care use were assessed over the 28 days after the molnupiravir pharmacy claim.
Findings: Among 26,554 patients identified, 71.1% were aged ≥50 years and 58.9% were female. A total of 8794 patients (33.1%) had received at least 1 dose of the COVID-19 vaccine. The most prevalent risk factors for severe COVID-19 identified were hypertension (45.1%), steroid and/or immunosuppressant use (39.6%), and being obese or overweight (24.6%), with 79.1% of patients having ≥1 risk factor. The majority (61.0%) of patients were prescribed comedications contraindicated with or had the potential for major drug-drug interactions with ritonavir-containing regimens. Within 28 days after initiating molnupiravir, 3.3% of patients were hospitalized for any cause and 1.7% for COVID-19-related reasons. Among all hospitalized patients, 9.2% were admitted to an intensive care unit, 3.9% received oxygen, and 3.8% required mechanical ventilation.
Implications: The majority of patients treated with molnupiravir in early 2022 had at least one risk factor for severe COVID-19 and had comedications that could require treatment modification or monitoring if given a ritonavir-containing regimen. Hospitalization was uncommon after treatment with molnupiravir, with COVID-19-related inpatient admission in <2% of patients. Among those hospitalized, patient use of intensive care and oxygen-based resources was infrequent. The study design, however, does not permit any conclusions regarding the effectiveness of molnupiravir.

Keywords: COVID-19; Health care resource use; Hospitalization; Inpatient intensive care; Molnupiravir.

 
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