Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large U.S. Health System
Dryden-Peterson et al., Annals of Internal Medicine,
doi:10.7326/M22-2141 (date from earlier preprint)
Dryden-Peterson et al.,
Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large U.S. Health System,
Annals of Internal Medicine, doi:10.7326/M22-2141 (date from earlier preprint)
IPW retrospective 44,551 outpatients age 50+ in the USA, showing lower mortality and hospitalization with paxlovid treatment.
[Hoertel] find that over 50% of patients that died had a contraindication for the use of Paxlovid. Retrospective studies that do not exclude contraindicated patients may significantly overestimate efficacy.
risk of death, 71.0% lower, RR 0.29, p = 0.006, treatment 11,797, control 32,248, propensity score weighting.
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risk of death/hospitalization, 44.0% lower, RR 0.56, p < 0.001, treatment 69 of 11,797 (0.6%), control 310 of 32,248 (1.0%), NNT 266, propensity score weighting.
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risk of hospitalization, 40.0% lower, RR 0.60, p = 0.001, treatment 11,797, control 32,248, propensity score weighting.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Dryden-Peterson et al., 16 Jun 2022, retrospective, USA, peer-reviewed, 12 authors, study period 1 January, 2022 - 17 July, 2022.
Contact:
sldrydenpeterson@bwh.harvard.edu.
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2022.06.14.22276393; this version posted June 16, 2022. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-ND 4.0 International license .
Title: Nirmatrelvir plus ritonavir for early COVID-19 and hospitalization in a large US health
system
Authors:
Scott Dryden-Peterson, MD, MSc
Andy Kim, BS
Arthur Y. Kim, MD
Ellen C. Caniglia, ScD
Inga Lennes, MD, MPH, MBA
Rajesh Patel, MD, MPH
Lindsay Gainer, RN
Lisa Dutton, RN
Elizabeth Donahue, RN, MSN, NP-C
Rajesh T. Gandhi, MD
Lindsey R. Baden, MD
Ann E. Woolley, MD, MPH
Author Affiliations:
Brigham and Women’s Hospital, Boston, Massachusetts (Dryden-Peterson, Kim, Baden, Dutton,
Donahue, Woolley);
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health
(Dryden-Peterson);
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
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medRxiv preprint doi: https://doi.org/10.1101/2022.06.14.22276393; this version posted June 16, 2022. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-ND 4.0 International license .
Botswana Harvard AIDS Institute (Dryden-Peterson);
Massachusetts General Hospital, Boston, Massachusetts (Kim, Lennes, Gandhi);
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Caniglia)
Mass General Brigham Integrated Care (Gainer);
Beth Israel Lahey Health, Cambridge, Massachusetts (Patel)
Corresponding Author: Scott Dryden-Peterson, MD, MSc, Division of Infectious Diseases,
Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115. Work: (617) 732-8881.
sldrydenpeterson@bwh.harvard.edu
Acknowledgement: This work was made possible with help from the Harvard University Center
for AIDS Research (CFAR), a funded program of the National Institutes of Health (P30 AI060354)
and the National Cancer Institute (R01 CA236546). The contents of this manuscript are solely
the responsibility of the authors and do not necessarily represent the official views of the
National Institutes of Health or the institutions with which the authors are affiliated. The
funding source had no role in the design and conduct of the study; collection, management,
analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and
decision to submit the manuscript for publication. Drs. Dryden-Peterson and Woolley had full
access to all the data in the study and take responsibility for the integrity of the data and the
accuracy of the data analysis.
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medRxiv preprint doi: https://doi.org/10.1101/2022.06.14.22276393; this version posted June 16, 2022. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-ND 4.0 International license .
Abstract:
Background: In the EPIC-HR trial, nirmatrelvir plus ritonavir led to an 88% reduction in
hospitalization or death among unvaccinated outpatients with early COVID-19. Clinical
impact of nirmatrelvir plus ritonavir among vaccinated populations is uncertain.
Objective: To assess..
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