- Paxlovid: what is it?
- Note: For whom is Paxlovid recommended?
- Paxlovid: are there any contraindications?
- Paxlovid: when and how to take it?
- How effective is Paxlovid?
- Paxlovid: a treatment to do without vaccination?
Since December 10, 2022, general practitioners have been authorized to prescribe the Paxlovid in prevention for people at risk of severe forms of Covid-19. According to the Minister of Health, it is “prescriptions that can be made by attending physicians in a preventive manner (therefore in anticipation) for a period of three months“. It will be usable in the event of a positive test for Covid-19. But what exactly is Paxlovid?
Paxlovid: what is it?
THE Paxlovid is a drug antiviral in pill form to swallowmade up of nirmatrelvir and of ritonavir and developed by Pfizer Laboratories. This medicine notably reduces the risk of a severe form in people who have been infected with SARS-CoV-2. According to Epi-Phare groupnext to 55,000 people had already received it in France at the end of October 2022. “You really need to use it a lot more“, insists Brigitte Autran, the president of the Committee for monitoring and anticipating health risks (Covars), replacing the Scientific Council.
Authorized by the French health authorities at the end of January 2022, Paxlovid has since been accessible in town and can be taken at home: France was then the 1er countries of the European Union to make this drug available, the first antiviral taken orally authorized in the European Union. On April 25, 2022, the High Authority for Health (HAS) had recommended its reimbursement in order to facilitate its access to patients.
Three treatments consisting of monoclonal antibodies are already covered on a special basis in France: Ronapreve, Evusheld and Xevudy.
Note: For whom is Paxlovid recommended?
This antiviral is indicated for adults infected with SARS-CoV-2 who do not require oxygen supplementation and who are at high risk of progression of their infection to a severe form of the disease.
The HAS recommends prescribing Paxlovid for adult patients at risk of a severe form of Covid-19, i.e.:
- THE adult patients severely immunocompromised or presenting a pathology at very high risk of severe form (in particular cancers being treated, polypathologies, trisomy 21 or certain rare diseases) regardless of their age and their vaccination status;
- the patients over 65 presenting risk factors for developing serious forms (diabetes, obesity, chronic renal failure, heart failure, arterial hypertension, respiratory failure, etc.), in particular when these people are not or not completely vaccinated.
Paxlovid: are there any contraindications?
Attention : Paxlovid is contraindicated in patients with severe kidney or liver failure. It is also contraindicated with drugs that are potent CYPA3 inducers, as co-administration may lead to a reduction in plasma concentrations, warns the HAS. Here is in detail the list of indications and contraindications.
The French Society of Pharmacology and Therapeutics (SFPT) also adds that the pharmacist must check that the patient “is not at foreseeable risk of developing a contraindication to Paxlovid“. Nevertheless, “most of the treatments prescribed chronically in the patient can be, if necessary, suspended without risk during the five days of the antiviral treatment“, reassures the SFPT.
In the event of a contraindication, there are other therapeutic solutions: the monoclonal antibody Xevudy as well as Evusheld.
Paxlovid: when and how to take it?
Easy to access, the Paxlovid comes in the form of tablets (2 tablets of nirmatrelvir PF-07321332 and 1 tablet of ritonavir) to be taken orally twice a day for five days. “It is recommended to administer it as soon as possible after the positive diagnosis for Covid-19 and at most within five days of the onset of symptoms“, indicates the HAS. It can therefore be taken at home, without the need for hospitalization.
Advance prescription permitted since 10 December therefore saves time and makes it easier to stay within the five-day window after symptoms start.
How it works ? The Paxlovid is a antiviral which targets the enzyme necessary for viral replication, the 3C-like protease, and by inhibiting its action, it blocks the replication of SARS-CoV-2 in the body.
How effective is Paxlovid?
According to a study published on December 13, 2022 in the journal Annals of Internal MedicinesPaxlovid reduces the risk of hospitalizations linked to Covid-19 by 40% and the risk of death by 70%. According to other data published by the Centers for Disease Control and Prevention on November 22, 2022, the risk of being hospitalized was halved. The Paxlovid is “A extremely effective treatment“against Covid-19says Brigitte Autran.
“The mechanism of action of Paxlovid gives hope for a maintained efficacy on the different variants, including Omicronunderlined the HAS in January 2022. Preliminary in vitro data indeed suggest that the variants of concern currently circulating are susceptible to treatment.”
In a press release published on December 9, the European Medicines Agency has claimed that “antiviral treatments such as Paxlovid should retain activity against emerging strains“, unlike monoclonal antibodies.
Paxlovid: a treatment to do without vaccination?
The answer is no. This is a vaccination complement, the most effective lever to avoid severe forms. HAS insists: Paxlovid is not intended to be used as a substitute for vaccination against SARS-CoV-2. More broadly, the implementation of anti-Covid-19 treatments does not exempt patients from compliance with barrier measures and physical distancing.
Sources :
- Paxlovid Associated with Decreased Hospitalization Rate Among Adults with COVID-19 — United States, April–September 2022, Centers for Disease Control and PreventionNovember 22, 2022
- Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large US Health System, Annals of Internal MedicinesDecember 13, 2022
- Arrival of a new drug against COVID-19: France deploys PAXLOVID® in the city, Ministry of HealthFebruary 2, 2022.
- Covid-19: early access granted to Paxlovid® as a curative treatment, HASJanuary 21, 2022
- “Pfizer’s Novel COVID-19 Oral Antiviral Treatment Candidate Reduced Risk of Hospitalization or Death by 89% in Interim Analysis of Phase 2/3 EPIC-HR Study”, Press release from the Pfizer laboratoryNovember 5, 2021