The CDC recommends antivirals in the first few days of illness for people at high risk of COVID-19, specifically the elderly, those with multiple comorbidities, and the immune compromised. For those who don’t respond well to vaccination, this recommendation is especially important. Also, because the evolution of SARS-CoV-2 virus has rendered monoclonal antibodies obsolete, antivirals remain the only available treatment early in infection. Currently, the first choice for an antiviral agent is nirmatrelvir-ritonavir (Paxlovid™). However, Paxlovid has several drug-drug interactions that make it difficult for some people to take. The second-line antiviral is remdesivir, which is limited by the fact that if can only be administered intravenously.
Researchers in Shanghai, China, recently compared Paxlovid with an oral form of remdesivir (VV116) to determine the relative efficacy of treating COVID-19 during an outbreak with the omicron variant (BA.1) (Cao Z, Gao W, Bao H, et al. VV116 Versus Nirmatrelvir-Ritonavir for Oral Treatment of COVID-19. N Engl J Med. 2023, Feb. 2;388(5):406-417). The primary endpoint was sustained recovery through the first 28 days after the beginning of therapy. The authors found that, “Among adults with mild-to-moderate Covid-19 who were at high risk for progression, VV116 was noninferior to nirmatrelvir-ritonavir with respect to the time to sustained clinical recovery, with fewer safety concerns” (p. 406).
The availability of an oral form of remdesivir for the treatment of COVID-19 would be an important advance in our fight against this disease.
The CDC recommends antivirals in the first few days of illness for people at high risk of COVID-19, specifically the elderly, those with multiple comorbidities, and the immune compromised. For those who don’t respond well to vaccination, this recommendation is especially important. Also, because the evolution of SARS-CoV-2 virus has rendered monoclonal antibodies obsolete, antivirals remain the only available treatment early in infection. Currently, the first choice for an antiviral agent is nirmatrelvir-ritonavir (Paxlovid™). However, Paxlovid has several drug-drug interactions that make it difficult for some people to take. The second-line antiviral is remdesivir, which is limited by the fact that if can only be administered intravenously.
Researchers in Shanghai, China, recently compared Paxlovid with an oral form of remdesivir (VV116) to determine the relative efficacy of treating COVID-19 during an outbreak with the omicron variant (BA.1) (Cao Z, Gao W, Bao H, et al. VV116 Versus Nirmatrelvir-Ritonavir for Oral Treatment of COVID-19. N Engl J Med. 2023, Feb. 2;388(5):406-417). The primary endpoint was sustained recovery through the first 28 days after the beginning of therapy. The authors found that, “Among adults with mild-to-moderate Covid-19 who were at high risk for progression, VV116 was noninferior to nirmatrelvir-ritonavir with respect to the time to sustained clinical recovery, with fewer safety concerns” (p. 406).
The availability of an oral form of remdesivir for the treatment of COVID-19 would be an important advance in our fight against this disease.