Paxlovid Shows No Benefit in Vaccinated Seniors, Study Shows

TOPLINE:

Treatment with Paxlovid in older adults did not appear to make a difference in whether or not they were hospitalized because of COVID-19.

METHODOLOGY:

• Over a 9-month time span starting in April 2022, researchers analyzed the hospital data of over 1.6 million Ontario residents aged 65 to 74 years.
• Nearly 88% of all patients had received at least two COVID-19 vaccines.
• The study followed Ontario’s age-restrictive policy, which reserved Paxlovid for adults aged ≥ 70 years with a positive COVID-19 test, unless they were immunocompromised or had fewer than three COVID-19 vaccinations plus another risk factor such as a diabetes diagnosis.
• Researchers compared outcomes of patients from ages 65 to 69 years and ages 70 to 74 years who were similar except for their exposure to Paxlovid.

TAKEAWAY:

• Nine months after an age-restricted policy in which only people aged > 70 years could get the drug; the rate of prescriptions was 227.9 per 100,000 patients per month vs 106 per 100,000 for those aged
• No significant differences were observed in COVID-19-related hospitalizations between patients 70 years (42.9 per 100,000 patients per month); absolute difference (AD), 3.4; 95% CI, −1.3 to 8.1; P = .15).
• All-cause hospitalizations showed no significant differences between patients above age 70 years (979.6 per 100,000 patients per month) and those below 70 (988.4 per 100,000 patients per month).
• All-cause mortality rates remained similar (AD, 6.1; 95% CI, −2.7 to 14.9; P = .17) across all ages.

IN PRACTICE:

“At best, nirmatrelvir-ritonavir could reduce COVID-19-related hospitalizations by 1.3 percentage points, which is four times smaller than the absolute risk reduction of 5.5 percentage points reported in the original nirmatrelvir-ritonavir trial among unvaccinated middle-aged adults,” the study authors wrote.

SOURCE:

The study was led by John Mafi, MD, MPH, of the Division of General Internal Medicine and Health Services Research at the David Geffen School of Medicine at UCLA in Los Angeles. It was published online on February 20 in JAMA Network Open.

LIMITATIONS:

The study did not include individual patient details such as symptoms, medication adherence, and the timing of COVID-19 vaccinations or PAXLOID administration. 

DISCLOSURES:

One study author reported receiving grants from the National Institute on Aging and Arnold Ventures, providing unpaid consulting to the Agency for Healthcare Research and Quality and Milliman MedInsight, and receiving nonfinancial support from Milliman MedInsight outside of the submitted work. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.