Molnupiravir for Nonsevere COVID-19 Added to Living Guideline

Molnupiravir recommended only for those at highest risk for hospitalization given its potential long-term harms

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FRIDAY, March 4, 2022 (HealthDay News) -- Molnupiravir is recommended for patients with nonsevere COVID-19 who are at the highest risk for hospitalization, according to the updated World Health Organization living guideline on drugs for COVID-19, published online March 2 in The BMJ.

Arnav Agarwal, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues presented the ninth version of the living guideline on drugs for the treatment of COVID-19, based on an evolving evidence base for therapeutics for COVID-19.

Based on data from six randomized controlled trials with 4,796 patients, the researchers added a new recommendation for molnupiravir in patients with nonsevere illness. Molnupiravir is recommended for those at highest risk for hospitalization and should be combined with implementation of mitigation strategies to reduce potential harms. No trial data were available for use of molnupiravir in patients with severe or critical illness. The recommendations for casirivimab-imdevimab have been updated as a result of the omicron variant; the conditional recommendation for their use for patients with nonsevere and severe or critical COVID-19 is restricted to cases where rapid viral genotyping is available and confirms infection with a susceptible variant. Preclinical evidence suggests that casirivimab-imdevimab lacks efficacy against the omicron BA1 variant. New trial data are currently being reviewed concerning use of remdesivir.

"The guideline is developed according to standards and methods for trustworthy guidelines, making use of an innovative process to achieve efficiency in dynamic updating of recommendations," the authors write.

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