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All Studies   All Outcomes    Recent:   
0 0.5 1 1.5 2+ Recovery time 29% Improvement Relative Risk Time to viral- 10% Viral clearance, day 10 51% Viral clearance, day 7 37% Viral clearance, day 5 18% Molnupiravir  Zou et al.  EARLY TREATMENT  RCT Is early treatment with molnupiravir beneficial for COVID-19? RCT 108 patients in China (March - March 2022) Faster viral clearance with molnupiravir (p=0.0092) Zou et al., Frontiers in Pharmacology, Jun 2022 Favors molnupiravir Favors control

Antiviral Efficacy and Safety of Molnupiravir Against Omicron Variant Infection: A Randomized Controlled Clinical Trial

Zou et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.939573, ChiCTR2200056817
Jun 2022  
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RCT 116 mild/moderate COVID-19 patients in China, showing improved viral clearance with treatment.
Concerns have been raised that the mutagenic mechanism of action may create dangerous variants or cause cancer Chamod, Hadj Hassine, Huntsman, Marikawa, Swanstrom, Waters, Zhou, Zibat. Multiple analyses have identified variants potentially created by molnupiravir Fountain-Jones, Kosakovsky Pond, Sanderson,
recovery time, 28.6% lower, relative time 0.71, p = 0.50, treatment 77, control 31.
time to viral-, 10.0% lower, relative time 0.90, p = 0.009, treatment 76, control 31.
risk of no viral clearance, 51.1% lower, RR 0.49, p = 0.02, treatment 18 of 76 (23.7%), control 15 of 31 (48.4%), NNT 4.0, day 10.
risk of no viral clearance, 36.7% lower, RR 0.63, p < 0.001, treatment 45 of 76 (59.2%), control 29 of 31 (93.5%), NNT 2.9, day 7.
risk of no viral clearance, 18.4% lower, RR 0.82, p = 0.009, treatment 62 of 76 (81.6%), control 31 of 31 (100.0%), NNT 5.4, day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Zou et al., 15 Jun 2022, Randomized Controlled Trial, China, peer-reviewed, 16 authors, study period 3 March, 2022 - 21 March, 2022, trial ChiCTR2200056817. Contact:,,,
This PaperMolnupiravirAll
Antiviral Efficacy and Safety of Molnupiravir Against Omicron Variant Infection: A Randomized Controlled Clinical Trial
Rongrong Zou, Ling Peng, Dan Shu, Lei Zhao, Jianfeng Lan, Guoyu Tan, Jinghan Peng, Xiangyi Yang, Miaona Liu, Chenhui Zhang, Jing Yuan, Huxiang Wang, Song Li, Hongzhou Lu, Wu Zhong, Yingxia Liu
Frontiers in Pharmacology, doi:10.3389/fphar.2022.939573
Background: The rapid worldwide spread of the Omicron variant of SARS-CoV-2 has unleashed a new wave of COVID-19 outbreaks. The efficacy of molnupiravir, an approved drug, is still unknown in patients infected with the Omicron variant. Objective: Evaluated the antiviral efficacy and safety of molnupiravir in patients infected with SARS-CoV-2 Omicron variant, with symptom duration within 5 days. Methods: We conducted a randomized, controlled trial involving patients with mild or moderate COVID-19. Patients were randomized to orally receive molnupiravir (800 mg) plus basic treatment or only basic treatment for 5 days (BID). The antiviral efficacy of the drug was evaluated using reverse transcriptase polymerase chain reaction. Results: Results showed that the time of viral RNA clearance (primary endpoint) was significantly decreased in the molnupiravir group (median, 9 days) compared to the control group (median, 10 days) (Log-Rank p = 0.0092). Of patients receiving molnupiravir, 18.42% achieved viral RNA clearance on day 5 of treatment, compared to the control group (0%) (p = 0.0092). On day 7, 40.79%, and 6.45% of patients in the molnupiravir and control groups, respectively, achieved viral RNA clearance (p = 0.0004). In addition, molnupiravir has a good safety profile, and no serious adverse events were reported. Conclusion: Molnupiravir significantly accelerated the SARS-CoV-2 Omicron RNA clearance in patients with COVID-19.
ETHICS STATEMENT The studies involving human participants were reviewed and approved by the Medical Ethics Committee of the Third People's Hospital of Shenzhen (No. 2022-034-02) . The patients/ participants provided their written informed consent to participate in this study. AUTHOR CONTRIBUTIONS SUPPLEMENTARY MATERIAL The Supplementary Material for this article can be found online at: full#supplementary-material Conflict of Interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's Note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Arora, Zhang, Rocha, Sidarovich, Kempf et al., Comparable Neutralisation Evasion of SARS-CoV-2 Omicron Subvariants BA.1, BA.2, and BA.3, Lancet. Infect. Dis, doi:10.1016/s1473-3099(22)00224-9
Bernal, Gomes Da Silva, Musungaie, Kovalchuk, Gonzalez et al., Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients, N. Engl. J. Med, doi:10.1056/NEJMoa2116044
Chen, Wang, Gilby, Wei, Omicron Variant (B.1.1.529): Infectivity, Vaccine Breakthrough, and Antibody Resistance, J. Chem. Inf. Model, doi:10.1021/acs.jcim.1c01451
Cheng, Ip, Chu, Tam, Chan et al., Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Subvariant BA.2 in a Single-Source Community Outbreak, Clin. Infect. Dis, doi:10.1093/cid/ciac203
Fischer, Eron, Jr, Holman, Cohen et al., A Phase 2a Clinical Trial of Molnupiravir in Patients with COVID-19 Shows Accelerated SARS-CoV-2 RNA Clearance and Elimination of Infectious Virus, doi:10.1126/scitranslmed.abl7430
He, Hong, Pan, Lu, Wei, SARS-CoV-2 Omicron Variant: Characteristics and Prevention, MedComm, doi:10.1002/mco2.110
Merck, Merck and Ridgeback's Molnupiravir, an Oral COVID-19 Antiviral Medicine
Rosenke, Okumura, Lewis, Feldmann, Meade-White et al., Molnupiravir Inhibits SARS-CoV-2 Variants Including Omicron in the Hamster Model, JCI Insight, doi:10.1172/jci.insight.160108
Saxena, Kumar, Ansari, Paweska, Maurya et al., Characterization of the Novel SARS-CoV-2 Omicron (B.1.1.529) Variant of Concern and its Global Perspective, J. Med. Virol, doi:10.1002/jmv.27524
Shuai, Chan, Hu, Chai, Yuen et al., Attenuated Replication and Pathogenicity of SARS-CoV-2 B.1.1.529 Omicron, Nature, doi:10.1038/s41586-022-04442-5
Takashita, Kinoshita, Yamayoshi, Sakai-Tagawa, Fujisaki et al., Efficacy of Antibodies and Antiviral Drugs against Covid-19 Omicron Variant, N. Engl. J. Med, doi:10.1056/NEJMc2119407
Uraki, Kiso, Iida, Imai, Takashita et al., Characterization and Antiviral Susceptibility of SARS-CoV-2 Omicron/BA.2, Nature, doi:10.1038/s41586-022-04856-1
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