Living Guideline Updated for Drug Treatment of COVID-19
Tenth version recommends nirmatrelvir/ritonavir in patients with confirmed COVID-19 who have highest risk for hospitalization
MONDAY, April 25, 2022 (HealthDay News) -- In the living guideline developed by the World Health Organization and published in The BMJ, recommendations on drug options for the treatment of COVID-19 have been updated.
Arnav Agarwal, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues issued a 10th version of the living guideline on drugs for COVID-19, developing new recommendations for patients with nonsevere COVID-19 and relating to use of nirmatrelvir/ritonavir (two randomized controlled trials [RCTs], with 3,100 participants) and remdesivir (five RCTs, with 2,710 participants).
The authors present a strong recommendation for use of nirmatrelvir/ritonavir in patients with confirmed COVID-19 who have the highest risk for hospitalization, while for patients with a low risk for hospitalization, a conditional recommendation was made against its use. Owing to an absence of trial data, no recommendation was made for nirmatrelvir/ritonavir in patients with severe or critical illness. A conditional recommendation was made for remdesivir for patients with the highest risk for hospitalization; this recommendation replaces a previous conditional recommendation against remdesivir for patients with COVID-19, regardless of disease severity.
"The strong recommendation for nirmatrelvir/ritonavir reflects what the guideline development group considered to represent a superior choice over other treatment options for those with nonsevere illness at highest risk; it may prevent more hospitalizations than the alternatives, has fewer harms than molnupiravir, and is easier to administer than intravenous options such as remdesivir and the monoclonal antibodies," the authors write.