Nirmatrelvir/Ritonavir Utilization for the Treatment of Non-hospitalized Adults with COVID-19 in the National Veterans Affairs (VA) Healthcare System
ConclusionsDespite increases over time, overall utilization of nirmatrelvir/ritonavir was low. Predictors of nirmatrelvir/ritonavir utilization were consistent with known risk factors for progression to severe COVID-19, including older age and underlying medical conditions. Unvaccinated and undervaccinated patients and those receiving potentially interacting medications for cardiovascular or mental health conditions (antiarrhythmic, alpha-1 antagonist, anticoagulant/antiplatelet, sedative/hypnotic/psychiatric) were less likely to receive nirmatrelvir/ritonavir. Further education of prescribers and patients about nirmatrelv...
Source: Infectious Diseases and Therapy - January 13, 2024 Category: Infectious Diseases Source Type: research
Viruses, Vol. 16, Pages 112: Exploring Paxlovid Efficacy in COVID-19 Patients with MAFLD: Insights from a Single-Center Prospective Cohort Study
This study investigates the intricate interplay between Metabolic-associated Fatty Liver Disease (MAFLD) and COVID-19, exploring the impact of MAFLD on disease severity, outcomes, and the efficacy of the antiviral agent Paxlovid (nirmatrelvir/ritonavir). MAFLD, affecting a quarter of the global population, emerges as a potential risk factor for severe COVID-19, yet the underlying pathophysiological mechanisms remain elusive. This study focuses on the clinical significance of Paxlovid, the first orally bioavailable antiviral agent granted Emergency Use Authorization in the United States. Notably, outcomes from phase II/III ...
Source: Viruses - January 12, 2024 Category: Virology Authors: Mykhailo Buchynskyi Valentyn Oksenych Iryna Kamyshna Oleksandr Kamyshnyi Tags: Article Source Type: research
Physiologically based pharmacokinetic modeling of ritonavir-oxycodone drug interactions and its implication for dosing strategy
This study was aimed to simulate DDI between ritonavir and oxycodone, a widely used opioid, and to formulate dosing protocols for oxycodone by using physiologically based pharmacokinetic (PBPK) modeling. We developed a ritonavir PBPK model incorporating induction and competitive and time-dependent inhibition of CYP3A4 and competitive inhibition of CYP2D6. The ritonavir model was evaluated with observed clinical pharmacokinetic data and validated for its CYP3A4 inhibition potency. We then used the model to simulate drug interactions between oxycodone and ritonavir under various dosing scenarios. The developed model captured...
Source: European Journal of Pharmaceutical Sciences - January 10, 2024 Category: Drugs & Pharmacology Authors: Liang Zheng Wei Zhang Klaus T Olkkola Andr é Dallmann Liang Ni Yingjie Zhao Ling Wang Qian Zhang Wei Hu Source Type: research
Public Health Impact of Paxlovid as Treatment for COVID-19, United States
Emerg Infect Dis. 2024 Jan 5;30(2). doi: 10.3201/eid3002.230835. Online ahead of print.ABSTRACTWe evaluated the population-level benefits of expanding treatment with the antiviral drug Paxlovid (nirmatrelvir/ritonavir) in the United States for SARS-CoV-2 Omicron variant infections. Using a multiscale mathematical model, we found that treating 20% of symptomatic case-patients with Paxlovid over a period of 300 days beginning in January 2022 resulted in life and cost savings. In a low-transmission scenario (effective reproduction number of 1.2), this approach could avert 0.28 million (95% CI 0.03-0.59 million) hospitalizatio...
Source: Emerging Infectious Diseases - January 5, 2024 Category: Infectious Diseases Authors: Yuan Bai Zhanwei Du Lin Wang Eric H Y Lau Isaac Chun-Hai Fung Petter Holme Benjamin J Cowling Alison P Galvani Robert M Krug Lauren Ancel Meyers Source Type: research
Public Health Impact of Paxlovid as Treatment for COVID-19, United States
Emerg Infect Dis. 2024 Jan 5;30(2). doi: 10.3201/eid3002.230835. Online ahead of print.ABSTRACTWe evaluated the population-level benefits of expanding treatment with the antiviral drug Paxlovid (nirmatrelvir/ritonavir) in the United States for SARS-CoV-2 Omicron variant infections. Using a multiscale mathematical model, we found that treating 20% of symptomatic case-patients with Paxlovid over a period of 300 days beginning in January 2022 resulted in life and cost savings. In a low-transmission scenario (effective reproduction number of 1.2), this approach could avert 0.28 million (95% CI 0.03-0.59 million) hospitalizatio...
Source: Emerging Infectious Diseases - January 5, 2024 Category: Infectious Diseases Authors: Yuan Bai Zhanwei Du Lin Wang Eric H Y Lau Isaac Chun-Hai Fung Petter Holme Benjamin J Cowling Alison P Galvani Robert M Krug Lauren Ancel Meyers Source Type: research
Public Health Impact of Paxlovid as Treatment for COVID-19, United States
Emerg Infect Dis. 2024 Jan 5;30(2). doi: 10.3201/eid3002.230835. Online ahead of print.ABSTRACTWe evaluated the population-level benefits of expanding treatment with the antiviral drug Paxlovid (nirmatrelvir/ritonavir) in the United States for SARS-CoV-2 Omicron variant infections. Using a multiscale mathematical model, we found that treating 20% of symptomatic case-patients with Paxlovid over a period of 300 days beginning in January 2022 resulted in life and cost savings. In a low-transmission scenario (effective reproduction number of 1.2), this approach could avert 0.28 million (95% CI 0.03-0.59 million) hospitalizatio...
Source: Emerging Infectious Diseases - January 5, 2024 Category: Infectious Diseases Authors: Yuan Bai Zhanwei Du Lin Wang Eric H Y Lau Isaac Chun-Hai Fung Petter Holme Benjamin J Cowling Alison P Galvani Robert M Krug Lauren Ancel Meyers Source Type: research
A Comprehensive Review of the Clinical Pharmacokinetics, Pharmacodynamics, and Drug Interactions of Nirmatrelvir/Ritonavir
AbstractNirmatrelvir is a potent and selective inhibitor of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease that is used as an oral antiviral coronavirus disease 2019 (COVID-19) treatment. To sustain unbound systemic trough concentrations above the antiviral in vitro 90% effective concentration value (EC90), nirmatrelvir is coadministered with 100 mg of ritonavir, a pharmacokinetic enhancer. Ritonavir inhibits nirmatrelvir ’s cytochrome P450 (CYP) 3A4-mediated metabolism which results in renal elimination becoming the primary route of nirmatrelvir elimination when dosed concomitantly. Nirma...
Source: Clinical Pharmacokinetics - January 4, 2024 Category: Drugs & Pharmacology Source Type: research
Small-molecule anti-COVID-19 drugs and a focus on China ’s homegrown mindeudesivir (VV116)
AbstractThe coronavirus disease 2019 (COVID-19) pandemic has stimulated tremendous efforts to develop therapeutic agents that target severe acute respiratory syndrome coronavirus 2 to control viral infection. So far, a few small-molecule antiviral drugs, including nirmatrelvir –ritonavir (Paxlovid), remdesivir, and molnupiravir have been marketed for the treatment of COVID-19. Nirmatrelvir–ritonavir has been recommended by the World Health Organization as an early treatment for outpatients with mild-to-moderate COVID-19. However, the existing treatment options have li mitations, and effective treatment strategies that ...
Source: Frontiers of Medicine - January 2, 2024 Category: General Medicine Source Type: research
In outpatients with COVID-19 during Omicron variant circulation, molnupiravir and nirmatrelvir-ritonavir improved outcomes
Ann Intern Med. 2024 Jan 2. doi: 10.7326/J23-0108. Online ahead of print.ABSTRACTSommer I, Ledinger D, Thaler K, et al. Outpatient treatment of confirmed COVID-19: a living, rapid evidence review for the American College of Physicians (version 2). Ann Intern Med. 2023;176:1377-1385. 37722115.PMID:38163374 | DOI:10.7326/J23-0108 (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - January 1, 2024 Category: Internal Medicine Authors: Zain Chagla Source Type: research
In outpatients with COVID-19 during Omicron variant circulation, molnupiravir and nirmatrelvir-ritonavir improved outcomes
Ann Intern Med. 2024 Jan 2. doi: 10.7326/J23-0108. Online ahead of print.ABSTRACTSommer I, Ledinger D, Thaler K, et al. Outpatient treatment of confirmed COVID-19: a living, rapid evidence review for the American College of Physicians (version 2). Ann Intern Med. 2023;176:1377-1385. 37722115.PMID:38163374 | DOI:10.7326/J23-0108 (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - January 1, 2024 Category: Internal Medicine Authors: Zain Chagla Source Type: research
In outpatients with COVID-19 during Omicron variant circulation, molnupiravir and nirmatrelvir-ritonavir improved outcomes
Ann Intern Med. 2024 Jan 2. doi: 10.7326/J23-0108. Online ahead of print.ABSTRACTSommer I, Ledinger D, Thaler K, et al. Outpatient treatment of confirmed COVID-19: a living, rapid evidence review for the American College of Physicians (version 2). Ann Intern Med. 2023;176:1377-1385. 37722115.PMID:38163374 | DOI:10.7326/J23-0108 (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - January 1, 2024 Category: Internal Medicine Authors: Zain Chagla Source Type: research
In outpatients with COVID-19 during Omicron variant circulation, molnupiravir and nirmatrelvir-ritonavir improved outcomes
Ann Intern Med. 2024 Jan 2. doi: 10.7326/J23-0108. Online ahead of print.ABSTRACTSommer I, Ledinger D, Thaler K, et al. Outpatient treatment of confirmed COVID-19: a living, rapid evidence review for the American College of Physicians (version 2). Ann Intern Med. 2023;176:1377-1385. 37722115.PMID:38163374 | DOI:10.7326/J23-0108 (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - January 1, 2024 Category: Internal Medicine Authors: Zain Chagla Source Type: research
In outpatients with COVID-19 during Omicron variant circulation, molnupiravir and nirmatrelvir-ritonavir improved outcomes
Ann Intern Med. 2024 Jan 2. doi: 10.7326/J23-0108. Online ahead of print.ABSTRACTSommer I, Ledinger D, Thaler K, et al. Outpatient treatment of confirmed COVID-19: a living, rapid evidence review for the American College of Physicians (version 2). Ann Intern Med. 2023;176:1377-1385. 37722115.PMID:38163374 | DOI:10.7326/J23-0108 (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - January 1, 2024 Category: Internal Medicine Authors: Zain Chagla Source Type: research
In outpatients with COVID-19 during Omicron variant circulation, molnupiravir and nirmatrelvir-ritonavir improved outcomes
Ann Intern Med. 2024 Jan 2. doi: 10.7326/J23-0108. Online ahead of print.ABSTRACTSommer I, Ledinger D, Thaler K, et al. Outpatient treatment of confirmed COVID-19: a living, rapid evidence review for the American College of Physicians (version 2). Ann Intern Med. 2023;176:1377-1385. 37722115.PMID:38163374 | DOI:10.7326/J23-0108 (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - January 1, 2024 Category: Internal Medicine Authors: Zain Chagla Source Type: research
