Nirmatrelvir and COVID-19: development, pharmacokinetics, clinical efficacy, resistance, relapse, and pharmacoeconomics.
Int J Antimicrob Agents
; 61(2): 106708, 2023 Feb.
Article
Dans Anglais
| MEDLINE | ID: covidwho-2165360
ABSTRACT
Nirmatrelvir/ritonavir (N/R) is one of the most effective antiviral drugs against SARS-CoV-2. The preclinical development, pharmacodynamics and pharmacokinetics of N/R are reviewed herein. Randomized clinical trials have been conducted exclusively with pre-Omicron variants of concern, but in vitro studies show that efficacy against all Omicron sublineages is preserved, as confirmed by post-marketing observational studies. Nevertheless, investigations of large viral genome repositories have shown that mutation in the main protease causing resistance to N/R are increasingly frequent. In addition, virological and clinical rebounds after N/R discontinuation have been reported in immunocompetent patients. This finding is of concern when translated to immunocompromised patients, in whom N/R efficacy has not been formally investigated in clinical trials. Economical sustainability and perspectives for this therapeutic arena are discussed.
Mots clés
Texte intégral:
Disponible
Collection:
Bases de données internationales
Base de données:
MEDLINE
Sujet Principal:
COVID-19
Type d'étude:
Études expérimentales
/
Étude observationnelle
/
Étude pronostique
/
Essai contrôlé randomisé
Les sujets:
Variantes
Limites du sujet:
Humains
langue:
Anglais
Revue:
Int J Antimicrob Agents
Année:
2023
Type de document:
Article
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