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Study: molnupiravir does not reduce COVID-19 deaths in vaccinated people at high risk

Molnupiravir does not reduce hospitalisations or deaths among higher risk, vaccinated adults with COVID-19 in the community, the University of Oxford’s PANORAMIC study has found.

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, a paper published in The Lancet reported.

Molnupiravir, brand name Lagevrio, was the first treatment to be studied by the PANORAMIC study, set up to identify which groups of higher risk people were most likely to benefit from new antiviral treatments for COVID-19.

The study - which recruited 25,000 people - allows multiple antiviral drugs to be tested in parallel. The NIHR Clinical Research Network Thames Valley and South Midlands is the lead clinical research network for the study, for which more than 1,000 people from Berkshire, Buckinghamshire, Milton Keynes and Oxfordshire were recruited via general practices.

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 from 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.”

Study participants were within five days of symptoms onset and either aged over 50 years in good health or between 18-50 with underlying health conditions that made them clinically more vulnerable.

A total of 25,786 study participants were randomly assigned to receive either molnupiravir or the usual standard of NHS care.

PANORAMIC is led by the University of Oxford and funded by UK Research and Innovation (UKRI) and National Institute for Health and Care Research (NIHR).

The study will now continue to investigate new antiviral medications such as Paxlovid. For more information or to enrol visit Read more about the results on the NIHR website.