Comparison of effectiveness and safety of molnupiravir versus sotrovimab for COVID‐19: A systematic review and meta‐analysis

{ 'indexed': {'date-parts': [[2024, 4, 24]], 'date-time': '2024-04-24T00:36:39Z', 'timestamp': 1713918999165}, 'reference-count': 48, 'publisher': 'Wiley', 'issue': '4', 'license': [ { 'start': { 'date-parts': [[2024, 4, 23]], 'date-time': '2024-04-23T00:00:00Z', 'timestamp': 1713830400000}, 'content-version': 'vor', 'delay-in-days': 22, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': ['onlinelibrary.wiley.com'], 'crossmark-restriction': True}, 'published-print': {'date-parts': [[2024, 4]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Background and ' 'Aim</jats:title><jats:p>This systematic review and meta‐analysis aimed to compare the ' 'effectiveness and safety of molnupiravir and sotrovimab in the treatment of patients with ' 'coronavirus disease 2019 ' '(COVID‐19).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Cochrane ' 'Library, Web of Science, PubMed, medRxiv, and Google Scholar were systematically searched to ' 'identify relevant evidence up to December 2023. The risk of bias was assessed using the risk ' 'of bias in nonrandomized studies of interventions tool. Data were analyzed using ' 'Comprehensive Meta‐Analysis ' '(CMA).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Our search ' 'identified and included 13 studies involving 16166 patients. The meta‐analysis revealed a ' 'significant difference between the molnupiravir and sotrovimab groups in terms of the ' 'mortality rate (odds ratio [OR]\u2009=\u20092.07, 95% confidence interval [CI]: 1.16, 3.70). ' 'However, no significant difference was observed between the two groups in terms of ' 'hospitalization rate (OR\u2009=\u20090.71, 95% CI: 0.47, 1.06), death or hospitalization rate ' '(OR\u2009=\u20091.51, 95% CI: 0.81, 2.83), and intensive care unit admission (OR\u2009=\u2009' '0.59, 95% CI: 0.07, 4.84). In terms of safety, molnupiravir was associated with a higher ' 'incidence of adverse events (OR\u2009=\u20091.67, 95% CI: 1.21, ' '2.30).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The current ' 'findings indicate that sotrovimab may be more effective than molnupiravir in reducing the ' 'mortality rate in COVID‐19 patients. However, no statistical difference was observed between ' 'the two treatments for other effectiveness outcomes. The certainty of evidence for these ' 'findings was rated as low or moderate. Further research is required to provide a better ' 'comparison of these interventions in treating COVID‐19 patients.</jats:p></jats:sec>', 'DOI': '10.1002/iid3.1262', 'type': 'journal-article', 'created': {'date-parts': [[2024, 4, 23]], 'date-time': '2024-04-23T13:44:49Z', 'timestamp': 1713879889000}, 'update-policy': 'http://dx.doi.org/10.1002/crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Comparison of effectiveness and safety of molnupiravir versus sotrovimab for COVID‐19: A ' 'systematic review and meta‐analysis', 'prefix': '10.1002', 'volume': '12', 'author': [ { 'given': 'Bahman', 'family': 'Amani', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Health Management and Economics, School of Public ' 'Health Tehran University of Medical Sciences Tehran Iran'}]}, { 'ORCID': 'http://orcid.org/0000-0003-4298-1807', 'authenticated-orcid': False, 'given': 'Behnam', 'family': 'Amani', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Health Management and Economics, School of Public ' 'Health Tehran University of Medical Sciences Tehran Iran'}]}], 'member': '311', 'published-online': {'date-parts': [[2024, 4, 23]]}, 'reference': [ { 'issue': '4', 'key': 'e_1_2_9_2_1', 'first-page': '520', 'article-title': 'Role of the 1st booster dose of COVID‐19 vaccine in the protection ' 'against the infection: a fundamental public health tool', 'volume': '63', 'author': 'Calimeri S', 'year': '2022', 'journal-title': 'J Prev Med Hyg'}, {'key': 'e_1_2_9_3_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41581-021-00491-7'}, {'key': 'e_1_2_9_4_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/jmv.27623'}, { 'key': 'e_1_2_9_5_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1080/07853890.2022.2034936'}, { 'key': 'e_1_2_9_6_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S1473-3099(22)00507-2'}, {'key': 'e_1_2_9_7_1', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/jcm11133769'}, { 'key': 'e_1_2_9_8_1', 'doi-asserted-by': 'crossref', 'unstructured': 'ZhengB CampbellJ CarrEJ et al.Comparative effectiveness of sotrovimab ' 'and molnupiravir for preventing severe COVID‐19 outcomes in ' 'non‐hospitalised patients on kidney replacement therapy: observational ' 'cohort study using the OpenSAFELY‐UKRR linked platform and SRR ' 'database.medRxiv. Preprint posted online December 4 ' '2022.doi:10.1101/2022.12.02.22283049', 'DOI': '10.1101/2022.12.02.22283049'}, {'key': 'e_1_2_9_9_1', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/v15081757'}, {'key': 'e_1_2_9_10_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jsps.2022.03.002'}, { 'issue': '5', 'key': 'e_1_2_9_11_1', 'doi-asserted-by': 'crossref', 'DOI': '10.1128/AAC.02428-20', 'article-title': 'Human safety, tolerability, and pharmacokinetics of molnupiravir, a ' 'novel broad‐spectrum oral antiviral agent with activity against ' 'SARS‐CoV‐2', 'volume': '65', 'author': 'Painter WP', 'year': '2021', 'journal-title': 'Antimicrob Agents Chemother'}, {'key': 'e_1_2_9_12_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1007/s43440-022-00408-6'}, {'key': 'e_1_2_9_13_1', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/v15030610'}, {'key': 'e_1_2_9_14_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1007/s40121-022-00729-2'}, {'key': 'e_1_2_9_15_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1007/s40121-022-00755-0'}, {'key': 'e_1_2_9_16_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/emp2.12958'}, { 'key': 'e_1_2_9_17_1', 'unstructured': 'Food and Drug Administration. Drug safety and ' 'availability.2022.https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-sotrovimab-emergency-use-authorization'}, { 'issue': '2', 'key': 'e_1_2_9_18_1', 'doi-asserted-by': 'crossref', 'first-page': '315', 'DOI': '10.1016/j.jiph.2023.11.029', 'article-title': 'Real world effectiveness of sotrovimab in preventing COVID‐19‐related ' 'hospitalisation or death in patients infected with Omicron BA.2', 'volume': '17', 'author': 'Behzad A', 'year': '2023', 'journal-title': 'J Infect Public Health'}, { 'issue': '4', 'key': 'e_1_2_9_19_1', 'doi-asserted-by': 'crossref', 'first-page': 'e104', 'DOI': '10.1016/j.jinf.2022.06.033', 'article-title': 'Sotrovimab to prevent severe COVID‐19 in high‐risk patients infected ' 'with Omicron BA.2', 'volume': '85', 'author': 'Martin‐Blondel G', 'year': '2022', 'journal-title': 'J Infect'}, { 'issue': '6', 'key': 'e_1_2_9_20_1', 'doi-asserted-by': 'crossref', 'first-page': '1300', 'DOI': '10.3390/v15061300', 'article-title': 'Clinical efficacy of the neutralizing antibody therapy sotrovimab in ' 'patients with SARS‐CoV‐2 omicron BA.1 and BA.2 subvariant infections', 'volume': '15', 'author': 'Miyashita N', 'year': '2023', 'journal-title': 'Viruses'}, {'key': 'e_1_2_9_21_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/rmv.2402'}, {'key': 'e_1_2_9_22_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/jmv.28621'}, { 'key': 'e_1_2_9_23_1', 'doi-asserted-by': 'crossref', 'DOI': '10.1136/bmj-2022-071932', 'article-title': 'Comparative effectiveness of sotrovimab and molnupiravir for prevention ' 'of severe covid‐19 outcomes in patients in the community: observational ' 'cohort study with the OpenSAFELY platform', 'volume': '379', 'author': 'Zheng B', 'year': '2022', 'journal-title': 'BMJ'}, { 'key': 'e_1_2_9_24_1', 'doi-asserted-by': 'crossref', 'unstructured': 'GleesonS MartinP ThomsonT et al.Kidney transplant recipients and ' 'omicron: outcomes effect of vaccines and the efficacy and safety of ' 'novel treatments.medRxiv. Preprint posted online May 3 ' '2022.doi:10.1101/2022.05.03.22274524', 'DOI': '10.1101/2022.05.03.22274524'}, {'key': 'e_1_2_9_25_1', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/v15020438'}, {'key': 'e_1_2_9_26_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/cts.13732'}, { 'key': 'e_1_2_9_27_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S1473-3099(21)00475-8'}, {'key': 'e_1_2_9_28_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijsu.2021.105906'}, {'key': 'e_1_2_9_29_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1136/bmj.i4919'}, { 'issue': '5', 'key': 'e_1_2_9_30_1', 'doi-asserted-by': 'crossref', 'first-page': '721', 'DOI': '10.3390/ph16050721', 'article-title': 'Molnupiravir, Nirmatrelvir/Ritonavir, or Sotrovimab for high‐risk ' 'COVID‐19 patients infected by the omicron variant: hospitalization, ' 'mortality, and time until negative swab test in real life', 'volume': '16', 'author': 'Cegolon L', 'year': '2023', 'journal-title': 'Pharmaceuticals'}, { 'key': 'e_1_2_9_31_1', 'doi-asserted-by': 'crossref', 'unstructured': 'DrysdaleM TibbleH PatelV et al.Characteristics and outcomes of patients ' 'with COVID‐19 at high risk of disease progression receiving sotrovimab ' 'oral antivirals or no treatment in Scotland.medRxiv. Preprint posted ' 'online June 9 2023.doi:10.1101/2023.06.09.23291195', 'DOI': '10.1101/2023.06.09.23291195'}, { 'issue': '4', 'key': 'e_1_2_9_32_1', 'doi-asserted-by': 'crossref', 'first-page': '352', 'DOI': '10.1016/j.jinf.2023.02.012', 'article-title': 'Real‐world effectiveness of molnupiravir, nirmatrelvir‐ritonavir, and ' 'sotrovimab on preventing hospital admission among higher‐risk patients ' 'with COVID‐19 in Wales: a retrospective cohort study', 'volume': '86', 'author': 'Evans A', 'year': '2023', 'journal-title': 'J Infect'}, { 'issue': '3', 'key': 'e_1_2_9_33_1', 'doi-asserted-by': 'crossref', 'DOI': '10.1371/journal.pone.0281915', 'article-title': 'Evaluation of outpatient treatment for non‐hospitalised patients with ' 'COVID‐19: the experience of a regional centre in the UK', 'volume': '18', 'author': 'Goodwin AT', 'year': '2023', 'journal-title': 'PLoS One'}, { 'key': 'e_1_2_9_34_1', 'doi-asserted-by': 'crossref', 'unstructured': 'KauerV TotschnigD AugustinM KarolyiM ZoufalyA NaegeliM.Efficacy and ' 'tolerability of Sotrovimab Molnupiravir and Nirmatrelvir/Ritonavir for ' 'non‐hospitalized patients at high risk for COVID‐19: a retrospective ' 'single‐center analysis. Preprint posted online April 10 ' '2023.doi:10.21203/rs.3.rs-2786240.v1', 'DOI': '10.21203/rs.3.rs-2786240/v1'}, { 'key': 'e_1_2_9_35_1', 'doi-asserted-by': 'crossref', 'DOI': '10.3389/fmed.2022.1036473', 'article-title': 'Effectiveness of the available early therapies in reducing severe ' 'COVID‐19 in non‐hospitalized patients with solid tumors on active ' 'treatment', 'volume': '9', 'author': 'Lasagna A', 'year': '2022', 'journal-title': 'Front Med'}, {'key': 'e_1_2_9_36_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/jmv.28186'}, { 'key': 'e_1_2_9_37_1', 'doi-asserted-by': 'crossref', 'unstructured': 'PatelV YarwoodMJ LevickB et al. Characteristics and outcomes of patients ' 'with COVID‐19 at high‐risk of disease progression receiving sotrovimab ' 'oral antivirals or no treatment in England.medRxiv. Preprint posted ' 'online November 29 2022.doi:10.1101/2022.11.28.22282808', 'DOI': '10.1101/2022.11.28.22282808'}, {'key': 'e_1_2_9_38_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/ajt.17098'}, { 'key': 'e_1_2_9_39_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1080/07853890.2022.2031274'}, { 'key': 'e_1_2_9_40_1', 'doi-asserted-by': 'crossref', 'DOI': '10.1016/j.antiviral.2023.105638', 'article-title': 'Activity of Sotrovimab against BQ.1.1 and XBB.1 Omicron sublineages in ' 'a hamster model', 'volume': '215', 'author': 'Driouich J‐S', 'year': '2023', 'journal-title': 'Antiviral Res'}, { 'key': 'e_1_2_9_41_1', 'doi-asserted-by': 'crossref', 'DOI': '10.1016/j.heliyon.2023.e16664', 'article-title': 'Sotrovimab retains activity against SARS‐CoV‐2 Omicron variant BQ.1.1 ' 'in a non‐human primate model', 'volume': '9', 'author': 'Hérate C', 'year': '2023', 'journal-title': 'Heliyon'}, {'key': 'e_1_2_9_42_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41598-022-08559-5'}, {'key': 'e_1_2_9_43_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41564-022-01170-4'}, { 'issue': '7', 'key': 'e_1_2_9_44_1', 'doi-asserted-by': 'crossref', 'first-page': '1586', 'DOI': '10.1093/jac/dkad132', 'article-title': 'Efficacy and safety of molnupiravir for the treatment of SARS‐CoV‐2 ' 'infection: a systematic review and meta‐analysis', 'volume': '78', 'author': 'Malin JJ', 'year': '2023', 'journal-title': 'J Antimicrob Chemother'}, { 'key': 'e_1_2_9_45_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijantimicag.2023.106870'}, { 'issue': '5', 'key': 'e_1_2_9_46_1', 'article-title': 'Efficacy of molnupiravir for the treatment of mild or moderate COVID‐19 ' 'in adults: a meta‐analysis', 'volume': '15', 'author': 'Benaicha K', 'year': '2023', 'journal-title': 'Cureus'}, {'key': 'e_1_2_9_47_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.cmi.2023.04.014'}, { 'issue': '1', 'key': 'e_1_2_9_48_1', 'doi-asserted-by': 'crossref', 'first-page': '192', 'DOI': '10.3390/v15010192', 'article-title': 'Early treatments of fragile children with COVID‐19—results of CLEVER ' '(Children COVID Early Treatment), a retrospective, observational study', 'volume': '15', 'author': 'Minotti C', 'year': '2023', 'journal-title': 'Viruses'}, {'key': 'e_1_2_9_49_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/bcp.15449'}], 'container-title': 'Immunity, Inflammation and Disease', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://onlinelibrary.wiley.com/doi/pdf/10.1002/iid3.1262', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2024, 4, 23]], 'date-time': '2024-04-23T13:44:56Z', 'timestamp': 1713879896000}, 'score': 1, 'resource': {'primary': {'URL': 'https://onlinelibrary.wiley.com/doi/10.1002/iid3.1262'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2024, 4]]}, 'references-count': 48, 'journal-issue': {'issue': '4', 'published-print': {'date-parts': [[2024, 4]]}}, 'alternative-id': ['10.1002/iid3.1262'], 'URL': 'http://dx.doi.org/10.1002/iid3.1262', 'relation': {}, 'ISSN': ['2050-4527', '2050-4527'], 'subject': [], 'container-title-short': 'Immunity Inflam &amp;amp; Disease', 'published': {'date-parts': [[2024, 4]]}, 'assertion': [ { 'value': '2023-09-04', 'order': 0, 'name': 'received', 'label': 'Received', 'group': {'name': 'publication_history', 'label': 'Publication History'}}, { 'value': '2024-04-12', 'order': 1, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'publication_history', 'label': 'Publication History'}}, { 'value': '2024-04-23', 'order': 2, 'name': 'published', 'label': 'Published', 'group': {'name': 'publication_history', 'label': 'Publication History'}}]}