Cet article est une Preprint
Les preprints sont des rapports de recherche préliminaires qui n'ont pas été certifiés par l’évaluation par les pairs. Ils ne devraient pas être considérés comme guidant la pratique clinique ou les comportements liés à la santé et ne devraient pas être rapportés dans les médias comme des informations établies.
Les preprints publiées en ligne permettent aux auteurs de recevoir des commentaires rapidement, et toute la communauté scientifique peut évaluer indépendamment le travail et répondre en conséquence. Ces commentaires sont publiés avec les preprints que quiconque peut lire et servir d’évaluation post-publication.
Comparative effectiveness of sotrovimab and molnupiravir for prevention of severe COVID-19 outcomes in non-hospitalised patients: an observational cohort study using the OpenSAFELY platform (preprint)
medrxiv; 2022.
Preprint
Dans Anglais
| medRxiv | ID: ppzbmed-10.1101.2022.05.22.22275417
ABSTRACT
Objective:
To compare the effectiveness of sotrovimab (a neutralising monoclonal antibody) vs. molnupiravir (an antiviral) in preventing severe COVID-19 outcomes in non-hospitalised high-risk COVID-19 adult patients.Design:
With the approval of NHS England, we conducted a real-world cohort study using the OpenSAFELY-TPP platform.Setting:
Patient-level electronic health record data were obtained from 24 million people registered with a general practice in England that uses TPP software. The primary care data were securely linked with data on COVID-19 infection and therapeutics, hospital admission and death within the OpenSAFELY-TPP platform, covering a period where both medications were frequently prescribed in community settings.Participants:
Non-hospitalised adult COVID-19 patients at high-risk of severe outcomes treated with sotrovimab or molnupiravir between December 16, 2021 and February 10, 2022.Interventions:
Sotrovimab or molnupiravir administered in the community by COVID-19 Medicine Delivery Units. Main outcomemeasure:
COVID-19 related hospitalisation or COVID-19 related death within 28 days after treatment initiation.Results:
Patients treated with sotrovimab (n=3288) and molnupiravir (n=2663) were similar with respect to most baseline characteristics. The mean age of all 5951 patients was 52 (SD=16) years; 59% were female, 89% White and 87% had three or more COVID-19 vaccinations. Within 28 days after treatment initiation, 84 (1.4%) COVID-19 related hospitalisations/deaths were observed (31 treated with sotrovimab and 53 with molnupiravir). Cox proportional hazards models stratified by area showed that after adjusting for demographics, high-risk cohort categories, vaccination status, calendar time, body mass index and other comorbidities, treatment with sotrovimab was associated with a substantially lower risk than treatment with molnupiravir (hazard ratio, HR=0.53, 95% CI 0.32-0.88; P=0.014). Consistent results were obtained from propensity score weighted Cox models (HR=0.51, 95% CI 0.31-0.83; P=0.007) and when restricted to fully vaccinated people (HR=0.52, 95% CI 0.30-0.90; P=0.020). No substantial effect modifications by other characteristics were detected (all P values for interaction>0.10).Conclusion:
In routine care of non-hospitalised high-risk adult patients with COVID-19 in England, those who received sotrovimab were at lower risk of severe COVID-19 outcomes than those receiving molnupiravir.
Texte intégral:
Disponible
Collection:
Preprints
Base de données:
medRxiv
langue:
Anglais
Année:
2022
Type de document:
Preprint
Documents relatifs à ce sujet
MEDLINE
...
LILACS
LIS