WHO recommends Merck’s COVID pill for high-risk patients

A World Health Organization (WHO) panel on Wednesday backed the use of Merck & Co Inc’s COVID-19 antiviral pill for high-risk patients.

The expert panel conditionally recommended the pill, molnupiravir, for patients with non-severe disease who are at high risk of hospitalisation, such as the immunocompromised, the unvaccinated, older people and those with chronic diseases.

The recommendation was based on new data from six clinical trials involving 4,796 patients.

Since molnupiravir’s U.S. authorization in December, demand for the pill among COVID-19 patients has taken a hit from comparatively low efficacy and potential safety issues for certain groups.

The WHO panel said it was also preparing recommendations for Pfizer Inc’s rival COVID-19 antiviral pill, Paxlovid.

Pfizer’s pill was shown to be nearly 90% effective in preventing COVID-19 hospitalizations and deaths, compared with 30% for molnupiravir.
The recommendations from the WHO’s Guideline Development Group (GDG) are aimed at helping doctors provide the best care for patients in fast-moving situations such as the COVID-19 pandemic.

The panel said that young and healthy patients, including children, and pregnant or breastfeeding women should not be given molnupiravir due to potential risks such as defects in a developing fetus, as shown in animal studies.

The WHO guidelines, published https://www.bmj.com/content/370/bmj.m3379 in the British Medical Journal, said no recommendation on molnupiravir’s use has been made for patients with severe or critical illness as there was no trial data for the group.

The panel also updated its guidance for the use of Regeneron Pharmaceuticals Inc’s COVID-19 antibody cocktail. It now recommends the drug only for people who are not infected with Omicron as new preclinical data has shown it is not effective against the variant.

In January, the panel recommended the use of Eli Lilly’s baricitinib for patients with severe COVID-19 in combination with corticosteroids, and conditionally endorsed GlaxoSmithKline and Vir Biotechnology‘s antibody therapy for non-severe patients at the highest risk of hospitalisation.

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