PDF(Pubmed)
Abstract：
BACKGROUND: Nirmatrelvir/ritonavir (NMV/r) is an oral antiviral drug used to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in patients aged 12 years or older at high risk of progression to severe disease (eg, hospitalization and death). Despite being the preferred option for outpatient treatment in the majority of countries worldwide, NMV/r is currently underutilized in real-world clinical practice.
UNASSIGNED: As numerous real-world studies have described patient outcomes following treatment with NMV/r, this systematic literature review provides a comprehensive summary of evidence on NMV/r effectiveness against hospitalization and mortality further organized by clinically meaningful categories, such as acute versus longer-term follow-up, age, underlying health conditions, and vaccination status, to help inform health care decision making.
METHODS: We searched Embase and PubMed (December 22, 2021-March 31, 2023) and congress abstracts (December 1, 2021-December 31, 2022) for reports describing NMV/r effectiveness.
UNASSIGNED: In total, 18 real-world studies met final selection criteria. The evidence showed that NMV/r significantly reduced postinfection risk of all-cause and COVID-19-related hospitalization and mortality in both acute (≤30 days) (21%-92%) and longer-term (>30 days) (1%-61%) follow-up. The reduction in postinfection risk was higher when treatment was received within 5 days of symptom onset. Real-world effectiveness of NMV/r treatment was observed regardless of age, underlying high-risk conditions, and vaccination status.
CONCLUSIONS: The systematic literature review findings demonstrated the effectiveness of NMV/r against hospitalization and mortality during the Omicron period among individuals at high risk of progression to severe COVID-19 disease.
UNASSIGNED: As numerous real-world studies have described patient outcomes following treatment with NMV/r, this systematic literature review provides a comprehensive summary of evidence on NMV/r effectiveness against hospitalization and mortality further organized by clinically meaningful categories, such as acute versus longer-term follow-up, age, underlying health conditions, and vaccination status, to help inform health care decision making.
METHODS: We searched Embase and PubMed (December 22, 2021-March 31, 2023) and congress abstracts (December 1, 2021-December 31, 2022) for reports describing NMV/r effectiveness.
UNASSIGNED: In total, 18 real-world studies met final selection criteria. The evidence showed that NMV/r significantly reduced postinfection risk of all-cause and COVID-19-related hospitalization and mortality in both acute (≤30 days) (21%-92%) and longer-term (>30 days) (1%-61%) follow-up. The reduction in postinfection risk was higher when treatment was received within 5 days of symptom onset. Real-world effectiveness of NMV/r treatment was observed regardless of age, underlying high-risk conditions, and vaccination status.
CONCLUSIONS: The systematic literature review findings demonstrated the effectiveness of NMV/r against hospitalization and mortality during the Omicron period among individuals at high risk of progression to severe COVID-19 disease.
摘要：
背景：Nirmatrelvir/利托那韦（NMV/r）是一种口服抗病毒药物，用于治疗12岁或以上的轻度至中度冠状病毒病2019（COVID-19）患者的进展为严重疾病的高风险（例如，住院和死亡)。尽管在世界大多数国家都是门诊治疗的首选选择，NMV/r目前在现实世界的临床实践中没有得到充分利用。
■由于许多真实世界的研究描述了NMV/r治疗后的患者结果，这篇系统的文献综述提供了关于NMV/r对住院和死亡率的有效性的证据的全面总结，进一步按临床有意义的类别进行组织，如急性和长期随访，年龄,潜在的健康状况，和疫苗接种状况，帮助告知医疗保健决策。
方法：我们搜索了Embase和PubMed（2021年12月22日至2023年3月31日）和国会摘要（2021年12月1日至2022年12月31日），以获取描述NMV/r有效性的报告。
■总共，18项真实世界研究符合最终选择标准。证据表明，在急性（≤30天）（21%-92%）和长期（>30天）（1%-61%）随访中，NMV/r均显著降低感染后全因和COVID-19相关住院风险和死亡率。当在症状发作后5天内接受治疗时，感染后风险的降低更高。无论年龄如何，都观察到NMV/r治疗的真实世界有效性，潜在的高风险状况，和疫苗接种状况。
结论：系统文献综述结果表明，在Omicron期间，NMV/r对严重COVID-19疾病进展风险高的个体的住院和死亡率具有有效性。
■由于许多真实世界的研究描述了NMV/r治疗后的患者结果，这篇系统的文献综述提供了关于NMV/r对住院和死亡率的有效性的证据的全面总结，进一步按临床有意义的类别进行组织，如急性和长期随访，年龄,潜在的健康状况，和疫苗接种状况，帮助告知医疗保健决策。
方法：我们搜索了Embase和PubMed（2021年12月22日至2023年3月31日）和国会摘要（2021年12月1日至2022年12月31日），以获取描述NMV/r有效性的报告。
■总共，18项真实世界研究符合最终选择标准。证据表明，在急性（≤30天）（21%-92%）和长期（>30天）（1%-61%）随访中，NMV/r均显著降低感染后全因和COVID-19相关住院风险和死亡率。当在症状发作后5天内接受治疗时，感染后风险的降低更高。无论年龄如何，都观察到NMV/r治疗的真实世界有效性，潜在的高风险状况，和疫苗接种状况。
结论：系统文献综述结果表明，在Omicron期间，NMV/r对严重COVID-19疾病进展风险高的个体的住院和死亡率具有有效性。
