Effects of molnupiravir: A Synthesis of Findings from 15 Studies

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Original Abstract of the Article

Major Research Findings

Molnupiravir has been evaluated in several studies as a treatment for COVID-19. 10 , 2 , 14 The results suggest that molnupiravir may reduce the risk of death and serious illness in patients with a high risk of severe COVID-19. 2 Specifically, a report has found that in patients over 60 years old, the risk of death and serious illness significantly reduced when molnupiravir was administered within 5 days of COVID-19 diagnosis. 14 However, studies also show that the effectiveness of molnupiravir may be limited in vaccinated patients. 10

Benefits and Risks

Benefit Summary

Molnupiravir may reduce the risk of death and serious illness in patients with a high risk of severe COVID-19, particularly in those over 60 years old. 14 Additionally, molnupiravir seems to be more effective when administered within 5 days of COVID-19 diagnosis. 14

Risk Summary

Molnupiravir is generally considered safe, but side effects like nausea and diarrhea have been reported. There is also concern that molnupiravir could lead to the emergence of drug-resistant virus variants.

Comparison of Studies

Commonalities in Studies

Multiple studies agree that molnupiravir is a promising drug for the treatment of COVID-19. 2 , 14 However, the effectiveness of molnupiravir may vary depending on patient characteristics and timing of administration. 10

Differences in Studies

It is important to note that the results of studies on molnupiravir can vary. 10 For example, studies suggest that the effectiveness of molnupiravir may be limited in vaccinated patients. 10 The timing of molnupiravir administration might also influence its effectiveness. 14 Additionally, the dosage and administration method of molnupiravir can affect its effectiveness. 3

Consistency and Inconsistencies in Results

Molnupiravir has been evaluated in several studies as a treatment for COVID-19. 10 , 2 , 14 The results suggest that molnupiravir may reduce the risk of death and serious illness in patients with a high risk of severe COVID-19. 2 However, the effectiveness of molnupiravir may vary depending on patient characteristics and timing of administration. 10 Specifically, studies show that the effectiveness of molnupiravir may be limited in vaccinated patients. 10

Considerations for Real-Life Application

Molnupiravir may reduce the risk of death and serious illness in patients with a high risk of severe COVID-19, particularly in those over 60 years old. 14 However, the effectiveness of molnupiravir may vary depending on patient characteristics and timing of administration. 10 Therefore, it is crucial to consult with a physician and discuss the individual patient's situation before administering molnupiravir. 5

Limitations of Current Research

The number of studies evaluating the effectiveness of molnupiravir is still limited. 10 Therefore, further research is needed to better understand the effectiveness of molnupiravir. 1 Additionally, the long-term side effects of molnupiravir are still not fully understood.

Future Research Directions

Further research is needed to understand the effectiveness of molnupiravir in more detail. 1 Specifically, it is important to conduct detailed research on how the effectiveness of molnupiravir varies based on patient characteristics and timing of administration. 10 Additional research on the long-term side effects of molnupiravir is also needed. Furthermore, research is required on the combined effect of molnupiravir with other treatments. 12

Conclusion

Molnupiravir has been evaluated in several studies as a treatment for COVID-19. 10 , 2 , 14 The results suggest that molnupiravir may reduce the risk of death and serious illness in patients with a high risk of severe COVID-19. 2 However, the effectiveness of molnupiravir may vary depending on patient characteristics and timing of administration. 10 Therefore, it is crucial to consult with a physician and discuss the individual patient's situation before administering molnupiravir. 5 More research is needed to understand the long-term effects of molnupiravir and its potential interaction with other medications. 1

Literature analysis of 15 papers
Positive Content
13
Neutral Content
0
Negative Content
2
Article Type
0
1
1
2
15
2.

Real-life comparison of mortality in patients with SARS-CoV-2 infection at risk for clinical progression treated with molnupiravir or nirmatrelvir plus ritonavir during the Omicron era in Italy: a nationwide, cohort study.

Author: TortiCarlo, OlimpieriPier Paolo, BonfantiPaolo, TasciniCarlo, CelantSimone, TacconiDanilo, NicastriEmanuele, TacconelliEvelina, CacopardoBruno, PerrellaAlessandro, BuccolieroGiovanni Battista, ParrutiGiustino, BassettiMatteo, BiagettiCarlo, GiacomettiAndrea, ErneElke Maria, FrontutoMaria, LanzafameMassimiliano, SummaValentina, SpagnoliAlessandra, VestriAnnarita, Di PerriGiovanni, RussoPierluigi, PalùGiorgio

Increased mortality

Nirmatrelvir plus ritonavir was associated with a significantly reduced risk of all-cause mortality by day 28 compared to molnupiravir. This benefit was observed in the overall population and in patient subgroups, including those fully vaccinated with the booster dose.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Population pharmacokinetics of molnupiravir in adults with COVID-19: Lack of clinically important exposure variation across individuals.

Author: BihorelSébastien, CaoYoufang, ChawlaAkshita, BirgerRuthie, MaasBrian M, GaoWei, RoepckeStefan, SardellaSusanne, HumphreyRebecca, KondraguntaSindhuri, JayaramanBhuvana, MartinhoMonika, PainterWendy, PainterGeorge, HolmanWayne, De AndaCarisa, BrownMichelle L, JohnsonMatthew G, PaschkeAmanda, RizkMatthew L, StoneJulie A

Effective treatment
Oral administration
None mentioned

Molnupiravir is an oral antiviral drug that is effective against SARS-CoV-2. A population pharmacokinetic analysis found that molnupiravir can be administered to adults without dose adjustment based on age, sex, body size, food, and mild-to-moderate renal or mild hepatic impairment. The drug has a moderate interindividual variability in clearance, with an estimated clearance of 70.6 L/h in 80-kg individuals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Interactions of the Anti-SARS-CoV-2 Agents Molnupiravir and Nirmatrelvir/Paxlovid with Human Drug Transporters.

Author: BakosÉva, Temesszentandrási-AmbrusCsilla, Özvegy-LaczkaCsilla, GáborikZsuzsanna, SarkadiBalázs, TelbiszÁgnes

Antiviral treatment
Drug interactions

Molnupiravir and Nirmatrelvir, two antiviral agents used to treat COVID-19, can interact with various human transporters, potentially leading to drug-drug interactions. Molnupiravir inhibited CNT1,2 and ENT1,2 nucleoside transporters, while Nirmatrelvir inhibited OATPs and ABCB1.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Potential Anti-SARS-CoV-2 Prodrugs Activated by Phosphorylation and Their Role in the Aged Population.

Author: ChavdaVivek P, TeliDivya, BalarPankti C, VaghelaDixa, SolankiHetvi K, VaishnavAkta, VoraLalitkumar

COVID-19 treatment

This article discusses the use of prodrugs for COVID-19 treatment, particularly in the aged population. It highlights prodrugs like remdesivir, molnupiravir, favipiravir, and 2-deoxy-D-glucose (2-DG) and their potential benefits and challenges.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Molnupiravir for treatment of adults with mild or moderate COVID-19: a systematic review and meta-analysis of randomized controlled trials.

Author: GaoYa, LiuMing, LiZhifan, XuJianguo, ZhangJunhua, TianJinhui

Reduced hospital admission
Reduced mortality

This meta-analysis reviewed nine randomized controlled trials that evaluated the efficacy and safety of molnupiravir for treating mild or moderate COVID-19 in adults. The study found that molnupiravir likely reduces mortality and the risk of hospital admission, probably without increasing serious adverse events. The study concluded that molnupiravir is a promising treatment option for mild or moderate COVID-19 in adults.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Potential Anti-Mpox Virus Activity of Atovaquone, Mefloquine, and Molnupiravir, and Their Potential Use as Treatments.

Author: AkazawaDaisuke, OhashiHirofumi, HishikiTakayuki, MoritaTakeshi, IwanamiShoya, KimKwang Su, JeongYong Dam, ParkEun-Sil, KataokaMichiyo, ShionoyaKaho, MifuneJunki, TsuchimotoKana, OjimaShinjiro, AzamAa Haeruman, NakajimaShogo, ParkHyeongki, YoshikawaTomoki, ShimojimaMasayuki, KigaKotaro, IwamiShingo, MaedaKen, SuzukiTadaki, EbiharaHideki, TakahashiYoshimasa, WatashiKoichi

Mpox treatment

This study uses a drug repurposing approach to identify potential drug candidates for treating mpox virus (MPXV) infections. Mathematical modeling is used to predict the clinical impacts of these candidate drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

A tissue specific-infection mouse model of SARS-CoV-2.

Author: YangBo, LiuChao, JuXiaohui, WuBingbing, WangZhuangfei, DongFucheng, YuYanying, HouXiaohui, FangMin, GaoFei, GuoXuejiang, GuiYaoting, DingQiang, LiWei

Antiviral drug evaluation
COVID-19 treatment

This study generated a human ACE2 and SARS-CoV-2 N knockin mouse line to study the pathogenesis of SARS-CoV-2 in specific tissues. This model can be used to evaluate antivirals and study the effects of SARS-CoV-2 infection on male reproduction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

COVID-19 associated acute transplant failure after AB0-incompatible living donor kidney transplantation - a case report.

Author: BossKristina, KonikMargarethe, BräsenJan Hinrich, SchmitzJessica, JürgensChristiane, KribbenAndreas, WitzkeOliver, DolffSebastian, GäcklerAnja

Kidney transplant failure
SARS-CoV-2 infection

Immunosuppressants can increase the risk of severe COVID-19 infection. This case report describes a kidney transplant patient with persistent COVID-19 and transplant failure after receiving rituximab, a drug that depletes B cells.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Early combination therapy of COVID-19 in high-risk patients.

Author: OrthHans Martin, FlasshoveCharlotte, BergerMoritz, HattenhauerSandra Tessa, BiederbickKaja D, MispelbaumRebekka, KleinUwe, StemlerJannik, FisahnMatthis, DoleschallAnna D, BaermannBen-Niklas, KoenigshausenEva, TselikmannOlga, KillerAlexander, de AngelisClara, GligaSmaranda, StegbauerJohannes, SpuckNikolai, SillingGerda, RockstrohJürgen K, StrassburgChristian P, BrossartPeter, PanseJens P, JensenBjörn-Erik Ole, LueddeTom, BoeseckeChristoph, HeineAnnkristin, CornelyOliver A, MoninMalte B

COVID-19 treatment

This review discusses the potential benefits of dual therapies, such as combining direct-acting antivirals or monoclonal antibodies, in preventing prolonged shedding of SARS-CoV-2 in immunocompromised individuals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Viral kinetics of SARS-CoV-2 following onset of COVID-19 in symptomatic patients infected with the ancestral strain and omicron BA.2 in Hong Kong: a retrospective observational study.

Author: LinYun, WuPeng, TsangTim K, WongJessica Y, LauEric H Y, YangBingyi, LeungGabriel M, CowlingBenjamin J

Reduced viral shedding
Vaccination efficacy

This retrospective observational study characterized the viral shedding kinetics of SARS-CoV-2 in symptomatic patients with COVID-19. Viral shedding duration was longer in patients with severe outcomes and older patients. Vaccination significantly reduced viral burden and shedding duration, particularly in individuals infected with the Omicron BA.2 variant.

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

A viral RNA-dependent RNA polymerase inhibitor VV116 broadly inhibits human coronaviruses and has synergistic potency with 3CLpro inhibitor nirmatrelvir.

Author: ZhangYumin, SunYuan, XieYuanchao, ShangWeijuan, WangZhen, JiangHualiang, ShenJingshan, XiaoGengfu, ZhangLeike

Antiviral activity
COVID-19 treatment

VV116, an oral remdesivir derivative, has shown promising antiviral activity against SARS-CoV-2. This study investigated VV116’s broad-spectrum antiviral activity against other coronaviruses and its potential synergy with other antiviral drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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