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A recent study published in The New England Journal of Medicine has cast doubt on the efficacy of Paxlovid, a combination of nirmatrelvir and ritonavir, in alleviating symptoms of COVID-19 among nonhospitalized adults. The findings suggest that the drug may not provide substantial relief for patients who are not at high risk for severe COVID-19.
The study, led by researchers from Massachusetts General Hospital in Boston, revealed that although the rate of hospitalization and death from any cause was low overall, the group receiving Paxlovid did show a reduced rate compared to those receiving a placebo. However, the time from onset to relief of COVID-19 symptoms did not differ significantly between the two study groups.
Dr. Rajesh T. Gandhi and Dr. Martin Hirsch, both from Massachusetts General Hospital, emphasized in an accompanying editorial that the observed benefit of Paxlovid does not extend to individuals at lower risk for severe COVID-19. They recommended that nirmatrelvir–ritonavir treatment should be reserved for those at high risk for disease progression.
Jennifer Hammond, PhD, head of antiviral development for Pfizer, the manufacturer of Paxlovid, highlighted a 57.6% relative reduction in the risk for hospitalizations or death among vaccinated individuals at high risk for poor outcomes who received Paxlovid.
The study analyzed data from 1250 adults with symptomatic COVID-19, including fully vaccinated individuals at high risk for disease progression and unvaccinated individuals without risk factors. The limitations of the study include the descriptive nature of the statistical analysis for primary efficacy endpoints and potential biases due to the telltale taste of Paxlovid, which may have impacted blinding.
While the study’s findings may prompt reassessment of Paxlovid’s role in treating COVID-19, Gandhi and Hirsch emphasized the importance of targeting treatment towards older patients, immunocompromised individuals, and those with conditions that increase the risk of severe illness.
Despite the limitations, the study provides valuable insights into the effectiveness of Paxlovid in treating COVID-19 and underscores the need for further research to optimize treatment strategies for different patient populations.
The study was supported by Pfizer.
Lauren Arcuri is a science journalist based in Vermont’s Northeast Kingdom.
