Low antiviral uptake of nirmatrelvir/ritonavir and molnupiravir in adult patients with COVID-19 in Taiwan in 2022
et al., Journal of Global Health, doi:10.7189/jogh.14.05032, Nov 2024
Retrospective 96,398 adult COVID-19 patients in Taiwan showing very low use of approved antivirals nirmatrelvir/ritonavir (5.1%) and molnupiravir (1.9%) in 2022, especially in moderate-to-high risk groups eligible for treatment per WHO guidelines. Barriers to use include the requirement for a prescription, time required for assessing drug interactions, perceived risks/benefits, and lack of awareness.
Potential risks of molnupiravir include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-15. Multiple analyses have identified variants potentially created by molnupiravir16-20.
Study covers molnupiravir and paxlovid.
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Wang et al., 8 Nov 2024, retrospective, Taiwan, peer-reviewed, 14 authors, study period January 2022 - December 2022.
Contact: jasonhsu@tmu.edu.tw.
Abstract: Cite as: Wang FD, Nguyen PA, Lee D, Taysi B, Lefebvre d‘Hellencourt F, Spinardi J, Phuc PT,
Burton W, Chang YH, Hien NTK, Lin SM, Chieh Y, Kyaw MH, Hsu JC. Low antiviral uptake
of nirmatrelvir/ritonavir and molnupiravir in adult patients with COVID-19 in Taiwan in
2022. J Glob Health 2024;14:05032.
Low antiviral uptake of nirmatrelvir/
ritonavir and molnupiravir in adult patients
with COVID-19 in Taiwan in 2022
Fu-Der Wang1,2, Phung-Anh Nguyen3,4,5,6 ,
David Lee7, Bulent Taysi8, Florence Lefebvre
d’Hellencourt9 , Julia Spinardi9, Phan Thanh
Phuc10 , Whitney Burton10, Yu-Hui Chang11,
Nguyen Thi Kim Hien12,13, Shiue-Ming Lin6, Yang
Chieh6, Moe H Kyaw9 , Jason C Hsu4,5,6,10
Background Antivirals are effective in reducing hospitalisation and death in mild-to-moderate coronavirus 2019 (COVID-19) patients. We estimated the antiviral uptake of nirmatrelvir/ritonavir and molnupiravir
in adult patients with a syndrome coronavirus 2 (SARSCoV-2) infection during the Emergency Use Authorization (EUA) period in Taiwan.
Division of Infectious Diseases, Department of Internal
Medicine, Taipei Medical University Hospital, Taipei, Taiwan
2
National Yang-Ming Chiao-Tung University, Taipei, Taiwan
3
Graduate Institute of Data Science, College of Management,
Taipei Medical University, Taipei, Taiwan
4
Clinical Data Center, Office of Data Science, Taipei Medical
University, Taipei, Taiwan
5
Clinical Big Data Research Center, Taipei Medical University
Hospital, Taipei Medical University, Taipei, Taiwan
6
Research Center of Health Care Industry Data Science, College
of Management, Taipei Medical University, Taipei, Taiwan
7
Pfizer, Taipei, Taiwan
8
Pfizer, Singapore
9
Pfizer, New York, USA
10
International PhD Program in Biotech and Healthcare
Management, College of Management, Taipei Medical
University, Taipei, Taiwan
11
School of Pharmacy, College of Pharmacy, Taipei Medical
University, Taipei, Taiwan
12
Master Program in Global Health and Development, College
of Public Health, Taipei Medical University, Taipei City, Taiwan
13
College of Nutrition, Taipei Medical University, Taipei City,
Taiwan
Methods A retrospective cohort study was conducted in
Taiwan between January 2022 and December 2022. Patients aged ≥18 years with a SARS-CoV-2 infection were
included from the Taipei Medical University Clinical Research Database (TMUCRD) and stratified in three risk
groups according to World Health Organization criteria.
1
Results In total, 96 398 COVID-19 patients (mean age
46.7 ± 17.7 years, 45.8% male) were included. Of these
patients 69.8% were classified as low risk, 29.8% as moderate risk, and 0.4% as high risk for progression to severe COVID-19. Nirmatrelvir/ritonavir was prescribed
in 5.1% of the COVID-19 patients (low risk = 1.0%,
moderate risk = 14.3%, high risk = 17.6%). Molnupiravir
was prescribed in 1.9% of the COVID-19 patients (low
risk = 0.1%, moderate risk = 5.8%, high risk = 6.9%).
Conclusions Nirmatrelvir/ritonavir and molnupiravir
were poorly used in the treatment of adult COVID-19
patients in Taiwan during the pandemic in 2022, especially in moderate-to-high risk groups for progression to
severe COVID-19.
Since its emergence in December 2019, coronavirus disease
2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to significant morbidity and mortality worldwide. As of April 2024, Taiwan
had nearly 10 million confirmed cases and 18 thousand
deaths due to COVID-19 [1].
Correspondence..
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