The effectiveness of Molnupiravir at treating COVID-19
Reviewed by Dat Tien Nguyen, B.A, ScM. Posted on August 1st, 2022
Molnupiravir is a ribonucleoside tautomer that is analogous to both cytidine and uridine. During viral RNA replication, molnupiravir is incorporated into the new copy. When the viral RNA polymerase encounters molnupiravir in the viral RNA template, the enzyme can interpret it as both cytidine and uridine; thus, this creates random mutations that will be lethal to the virus. Molnupiravir is approved by the Federal Drug Administration to treat mild and moderate COVID-19. As a part of the approval process, the trial had published their findings on the effect that molnupiravir has on COVID-19 hoặc and associated biomarkers.
The phase 3 clinical trial included 1433 participants that has mild-to-moderate COVID-19. These participants are not hospitalized at enrollment, and they are randomly assigned to receive either placebo or 800 mg of Molnupiravir every 12 hour for 5 days. The participants were followed for 29 days and those in the treatment group experienced a significantly faster rate of symptoms resolution and recovery. The C-reactive protein (CRP) level - a biomarker that is indicative to inflammation - of the treatment group reduced at around the 3rd day; whereas, CRP of the placebo group did not decrease until the 10th day. Because inflammation is the driving factor behind respiratory failure and COVID-19 severity, this temporal pattern is also observed in the oxygen saturation level. Clinically, molnupiravir reduce the need for respiratory interventions by 34.3% and visit to acute care facility by 33.8%. For a subgroup of participants that were hospitalized, molnupiravir reduces the need for respiratory intervention by 21.3%, and they were discharged 3 days earlier than those who were in the control group.
Molnupiravir had been included in the clinical guideline to help manage COVID-19 in non-hospitalized adults. It can be prescribed as an alternative if both Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Remdesivir are either not available or not contraindicated for the patient. Molnupiravir (800 mg) can be taken orally twice daily for 5 days.
The phase 3 clinical trial included 1433 participants that has mild-to-moderate COVID-19. These participants are not hospitalized at enrollment, and they are randomly assigned to receive either placebo or 800 mg of Molnupiravir every 12 hour for 5 days. The participants were followed for 29 days and those in the treatment group experienced a significantly faster rate of symptoms resolution and recovery. The C-reactive protein (CRP) level - a biomarker that is indicative to inflammation - of the treatment group reduced at around the 3rd day; whereas, CRP of the placebo group did not decrease until the 10th day. Because inflammation is the driving factor behind respiratory failure and COVID-19 severity, this temporal pattern is also observed in the oxygen saturation level. Clinically, molnupiravir reduce the need for respiratory interventions by 34.3% and visit to acute care facility by 33.8%. For a subgroup of participants that were hospitalized, molnupiravir reduces the need for respiratory intervention by 21.3%, and they were discharged 3 days earlier than those who were in the control group.
Molnupiravir had been included in the clinical guideline to help manage COVID-19 in non-hospitalized adults. It can be prescribed as an alternative if both Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Remdesivir are either not available or not contraindicated for the patient. Molnupiravir (800 mg) can be taken orally twice daily for 5 days.