Molnupiravir Does Not Reduce Covid-19 Hospitalisation- A Finding By PANORAMIC

Researchers have today released findings from a clinical trial investigating the effectiveness of the antiviral treatment molnupiravir against COVID-19 – the first treatment tested in the ongoing PANORAMIC trial.

The Platform Adaptive trial of NOvel antiviRals for eArly treatMent of COVID-19 In the Community (PANORAMIC) was developed by Professor Sir Jonathan Van-Tam, Pro-Vice-Chancellor for the Faculty of Medicine & Health Sciences at the University of Nottingham, and Chris Butler, Professor of Primary Care in the Nuffield Department of Primary Care Health Sciences and co-Chief Investigator of PANORAMIC.

PANORAMIC is led by a team of researchers at the University of Oxford and funded by UK Research and Innovation (UKRI) and National Institute for Health and Care Research (NIHR). (NIHR135366). The trial is being used to identify which groups of higher risk people were most likely to benefit from new antiviral treatments for COVID-19. The study allows multiple antiviral drugs to be tested in parallel.

In the paper published in The Lancet, they reported that molnupiravir did not reduce hospitalisations or deaths among higher risk, vaccinated adults with COVID-19 in the community. The treatment was, however, associated with a faster recovery time and reduced viral detection and load – participants who received molnupiravir reported feeling better compared to those who received usual care.

Commenting on the findings, Professor Sir Jonathan Van-Tam said: “While molnupiravir was originally found to work well to reduce hospitalisation in patients with Covid, these were unvaccinated patients.

“This latest research has repeated the exercise in the highly vaccinated population, demonstrating that the vaccine protection is so strong that there is no obvious benefit from the drug in terms of further reducing hospitalisation and deaths.

“However, symptom duration and virus shedding are both markedly reduced, and we must wait much longer to know if there will be any discernible effects on Long Covid.

“This study is an excellent example of why large-scale, rigorous, prospective trials like this are so essential in assessing the effectiveness of drugs to ensure that they are only used in patients where there will be a tangible benefit to their care.”

Chris Butler, Professor of Primary Care in the Nuffield Department of Primary Care Health Sciences and co-Chief Investigator of PANORAMIC, said: “Finding effective, safe and scalable early treatments for COVID-19 in the community is the next major frontier in our research response to the ongoing worldwide pandemic. It is in the community where treatments could have a massive reach and impact. But decisions about who to treat should always be based on evidence from rigorous clinical trials that involve people who would most likely be prescribed the drugs.

“The evidence PANORAMIC has produced about molnupiravir will guide treatment decisions for COVID-19 world-wide. It is rapidly generating critically important clinical evidence from within the pandemic to guide care during the pandemic itself, in this case determining effects of molnupiravir among people who are almost all vaccinated.

“We must not forget the other ongoing pandemic of antibiotic resistance, which in part stems from using antimicrobial drugs at scale before we did rigorous clinical trials to find out who really benefits form treatment, and who does not. The PANORAMIC team is also doing the necessary trials and gathering evidence about these treatments before we go straight to widespread use.”