GENEVA: The World Health Organization (WHO) said Friday (Apr 22) it “strongly recommended” Pfizer’s COVID-19 antiviral pill Paxlovid for patients with milder forms of the disease who were still at a high risk of hospitalisation.
However the UN agency warned it was “extremely concerned” that the inequality in access seen with COVID-19 vaccines would again leave low- and middle-income countries “pushed to the end of the queue”.
US pharma giant Pfizer’s combination of nirmatrelvir and ritonavir was the “superior choice” of treatment for unvaccinated, elderly or immunocompromised people with COVID-19, the WHO’s experts said in the BMJ medical journal.
For the same patients, the WHO also made a “conditional (weak) recommendation” of the antiviral drug remdesivir made by US biotech firm Gilead – which it had previously recommended against.
The WHO recommended Paxlovid over remdesivir, as well as over Merck’s molnupiravir pill and monoclonal antibodies.
Pfizer’s oral treatment prevents hospitalisation more than the “available alternatives, has fewer concerns with respects to harms than molnupiravir, and is easier to administer than intravenous remdesivir and antibodies”, the WHO’s experts said.
The new recommendation was based on the findings of two trials involving almost 3,100 patients which showed that Paxlovid reduced the risk of hospital admission by 85 per cent.
The trials also “suggested no important difference in mortality” and “little or no risk of adverse effects leading to drug discontinuation”.
The recommendation applies to people over the age of 18, but not to pregnant or breastfeeding women.
It also does not apply to patients with a low risk of complications from the disease, because the benefit would be minimal.
The WHO’s experts also declined to give an opinion for patients with severe forms of the disease, due to a lack of data.
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