Overview
- Two large community trials, published Wednesday in the New England Journal of Medicine, found that the oral antiviral Paxlovid (nirmatrelvir-ritonavir) did not lower hospitalization or death in mostly vaccinated higher-risk adults.
- Paxlovid recipients recovered sooner and cleared virus faster, with PANORAMIC showing 29.2% had undetectable virus by day 5 versus 16.5% with usual care, which points to clear antiviral activity despite limited effect on severe outcomes.
- Hospitalization or death remained rare and statistically similar across groups, registering 0.8% with Paxlovid versus 0.7% with usual care in the UK PANORAMIC trial and 0.6% versus 1.2% in Canada’s CanTreatCOVID, with no deaths during Paxlovid enrollment.
- The studies enrolled adults aged 50 and over or younger adults with conditions like diabetes or asthma, with more than 98% vaccinated, and both used open-label designs, with CanTreatCOVID stopping early because enrollment lagged and drug supply ended.
- The results back targeted use for people at the very highest risk, echoing prior UK guidance that narrowed routine access, which means clinicians may prioritize immunocompromised patients and weigh quicker recovery against common side effects like altered taste.