Head-to-head comparison of azvudine and nirmatrelvir/ritonavir for the hospitalized patients with COVID-19: a real-world retrospective cohort study with propensity score matching

{ 'indexed': { 'date-parts': [[2023, 10, 14]], 'date-time': '2023-10-14T11:46:17Z', 'timestamp': 1697283977332}, 'reference-count': 26, 'publisher': 'Frontiers Media SA', 'license': [ { 'start': { 'date-parts': [[2023, 10, 13]], 'date-time': '2023-10-13T00:00:00Z', 'timestamp': 1697155200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': ['frontiersin.org'], 'crossmark-restriction': True}, 'abstract': '<jats:p><jats:bold>Background:</jats:bold> Nirmatrelvir/ritonavir and azvudine have been ' 'approved for the early treatment of COVID-19 in China, however, limited real-world data ' 'exists regarding their effectiveness and ' 'safety.</jats:p><jats:p><jats:bold>Methods:</jats:bold> We conducted a retrospective cohort ' 'study involving the hospitalized COVID-19 patients in China between December 2022 and January ' '2023. Demographic, clinical, and safety variables were ' 'recorded.</jats:p><jats:p><jats:bold>Results:</jats:bold> Among the 6,616 hospitalized ' 'COVID-19 patients, we included a total of 725 patients including azvudine recipients (N = ' '461) and nirmatrelvir/ritonavir (N = 264) recipients after exclusions and propensity score ' 'matching (1:2). There was no significant difference in the composite disease progression ' 'events between azvudine (98, 21.26%) and nirmatrelvir/ritonavir (72, 27.27%) groups ' '(<jats:italic>p</jats:italic> = 0.066). Azvudine was associated with a significant reduction ' 'in secondary outcomes, including the percentage of intensive care unit admission ' '(<jats:italic>p</jats:italic> = 0.038) and the need for invasive mechanical ventilation ' '(<jats:italic>p</jats:italic> = 0.035), while the in-hospital death event did not ' 'significantly differ (<jats:italic>p</jats:italic> = 0.991). As for safety outcomes, 33 out ' 'of 461 patients (7.16%) in azvudine group and 22 out of 264 patients (8.33%) in ' 'nirmatrelvir/ritonavir group experienced drug-related adverse events between the day of ' 'admission (<jats:italic>p</jats:italic> = ' '0.565).</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> In our real-world setting, ' 'azvudine treatment demonstrated similar safety compared to nirmatrelvir/ritonavir in ' 'hospitalized COVID-19 patients. Additionally, it showed slightly better clinical benefits in ' 'this population. However, further confirmation through additional clinical trials is ' 'necessary.</jats:p>', 'DOI': '10.3389/fphar.2023.1274294', 'type': 'journal-article', 'created': { 'date-parts': [[2023, 10, 13]], 'date-time': '2023-10-13T05:02:57Z', 'timestamp': 1697173377000}, 'update-policy': 'http://dx.doi.org/10.3389/crossmark-policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Head-to-head comparison of azvudine and nirmatrelvir/ritonavir for the hospitalized patients ' 'with COVID-19: a real-world retrospective cohort study with propensity score matching', 'prefix': '10.3389', 'volume': '14', 'author': [ {'given': 'An-Hua', 'family': 'Wei', 'sequence': 'first', 'affiliation': []}, {'given': 'Lu', 'family': 'Zeng', 'sequence': 'additional', 'affiliation': []}, {'given': 'Lu', 'family': 'Wang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Lin', 'family': 'Gui', 'sequence': 'additional', 'affiliation': []}, {'given': 'Wen-Ting', 'family': 'Zhang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Xue-Peng', 'family': 'Gong', 'sequence': 'additional', 'affiliation': []}, {'given': 'Juan', 'family': 'Li', 'sequence': 'additional', 'affiliation': []}, {'given': 'Dong', 'family': 'Liu', 'sequence': 'additional', 'affiliation': []}], 'member': '1965', 'published-online': {'date-parts': [[2023, 10, 13]]}, 'reference': [ { 'key': 'B1', 'doi-asserted-by': 'publisher', 'first-page': 'e28441', 'DOI': '10.1002/jmv.28441', 'article-title': 'Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID-19: ' 'a rapid review and meta-analysis', 'volume': '95', 'author': 'Amani', 'year': '2023', 'journal-title': 'J. 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