{"id":23350,"date":"2023-01-12T01:51:00","date_gmt":"2023-01-11T17:51:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23350"},"modified":"2023-01-12T06:02:12","modified_gmt":"2023-01-11T22:02:12","slug":"lancet%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%97%a9%e6%9c%9f%e4%bd%bf%e7%94%a8%e8%8e%ab%e5%8a%aa%e5%8c%b9%e9%9f%a6%e4%b8%8e%e5%8d%95%e7%ba%af%e5%b8%b8%e8%a7%84%e6%b2%bb%e7%96%97%e7%94%a8","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23350","title":{"rendered":"[Lancet\u53d1\u8868\u8bba\u6587]\uff1a\u65e9\u671f\u4f7f\u7528\u83ab\u52aa\u5339\u97e6\u4e0e\u5355\u7eaf\u5e38\u89c4\u6cbb\u7597\u7528\u4e8e\u5177\u6709\u4e0d\u826f\u9884\u540e\u98ce\u9669\u7684\u65b0\u51a0\u80ba\u708e\u6210\u5e74\u60a3\u8005"},"content":{"rendered":"\n

RTICLES|ONLINE FIRST<\/a><\/p>\n\n\n\n

Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial<\/h1>\n\n\n\n

Christopher C Butler, F D Richard Hobbs, Oghenekome A Gbinigie, et al<\/h3>\n\n\n\n

Lancet AccessPublished:December 22, 2022<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/S0140-6736(22)02597-1<\/a><\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

PANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial. Eligible participants were aged 50 years or older\u2014or aged 18 years or older with relevant comorbidities\u2014and had been unwell with confirmed COVID-19 for 5 days or fewer in the community. Participants were randomly assigned (1:1) to receive 800 mg molnupiravir twice daily for 5 days plus usual care or usual care only. A secure, web-based system (Spinnaker) was used for randomisation, which was stratified by age (<50 years vs<\/em> \u226550 years) and vaccination status (yes vs<\/em> no). COVID-19 outcomes were tracked via a self-completed online daily diary for 28 days after randomisation. The primary outcome was all-cause hospitalisation or death within 28 days of randomisation, which was analysed using Bayesian models in all eligible participants who were randomly assigned. This trial is registered with ISRCTN, number 30448031.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

Between Dec 8, 2021, and April 27, 2022, 26\u2009411 participants were randomly assigned, 12\u2009821 to molnupiravir plus usual care, 12\u2009962 to usual care alone, and 628 to other treatment groups (which will be reported separately). 12\u2009529 participants from the molnupiravir plus usual care group, and 12\u2009525 from the usual care group were included in the primary analysis population. The mean age of the population was 56\u00b76 years (SD 12\u00b76), and 24\u2009290 (94%) of 25\u2009708 participants had had at least three doses of a SARS-CoV-2 vaccine. Hospitalisations or deaths were recorded in 105 (1%) of 12\u2009529 participants in the molnupiravir plus usual care group versus 98 (1%) of 12\u2009525 in the usual care group (adjusted odds ratio 1\u00b706 [95% Bayesian credible interval 0\u00b781\u20131\u00b741]; probability of superiority 0\u00b733). There was no evidence of treatment interaction between subgroups. Serious adverse events were recorded for 50 (0\u00b74%) of 12\u2009774 participants in the molnupiravir plus usual care group and for 45 (0\u00b73%) of 12\u2009934 in the usual care group. None of these events were judged to be related to molnupiravir.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

UK National Institute for Health and Care Research<\/p>\n","protected":false},"excerpt":{"rendered":"

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