#nirmatrelvir/ritonavir

[quotesfrommyreading]

The pandemic was destined to come after older Americans. Their immune systems tend to be weaker, making it harder for them to fight off an infection, and they are more likely to have comorbidities, which further increases their risk of severe illness. The precarity that many of them already faced going into 2020—poverty, social isolation and loneliness, inadequate personal care—left them poorly equipped for the arrival of the novel coronavirus. More than 1 million people lived in nursing homes, many of which were densely packed and short on staff when COVID tore through them.

A major reason older people are still at risk is that vaccines can’t entirely compensate for their immune systems. A study recently published in the journal Vaccines showed that for vaccinated adults ages 60 and over, the risk of dying from COVID versus other natural causes jumped from 11 percent to 34 percent within a year of completing their primary shot series. A booster dose brings the risk back down, but other research shows that it wears off too. A booster is a basic precaution, but “not one that everyone is taking,” Black, a co-author of the study, told me. Booster uptake among older Americans for the reengineered “bivalent” shots is the highest of all age groups, but still, nearly 60 percent have not gotten one.

For every COVID death, many more older people develop serious illness. Risk increases with age, and people older than 70 “have a substantially higher rate of hospitalizations” than those ages 60 to 69, Caitlin Rivers, an epidemiologist at Johns Hopkins University, told me. Unlike younger people, most of whom fully recover from a bout with COVID, a return to baseline health is less guaranteed for older adults. In one study, 32 percent of adults over 65 were diagnosed with symptoms that lasted well beyond their COVID infection. Persistent coughs, aches, and joint pain can linger long after serious illness, together with indirect impacts such as loss of muscle strength and flexibility, which can affect older people’s ability to be independent, Rivers said. Older COVID survivors may also have a higher risk of cognitive decline. In some cases, these ailments could be part of long COVID, which may be more prevalent in older people.

Certainly, some older adults are able to make a full recovery. Brangman said she has “old and frail” geriatric patients who bounced back after flu-like symptoms, and younger ones who still experience weakness and fatigue. Still, these are not promising odds. The antiviral Paxlovid was supposed to help blunt the wave of old people falling sick and ending up in the hospital—and it can reduce severe disease by 50 to 90 percent. But unfortunately, it is not widely used; as of July, just a third of Americans 80 or older took Paxlovid.

The reality is that as long as the virus continues to be prevalent, older Americans will face these potential outcomes every time they leave their home. That doesn’t mean they will barricade themselves indoors, or that they even should. Still, “every decision that we make now is weighing that balance between risk and socialization,” Brangman said.

  —  Life Is Worse for Older People Now

[tumbwr]

this thang can fit so many pills inside of her

[healthcare7463]

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[covid-safer-hotties]

Also preserved in our archive (Daily updates!)

By Mary Van Beusekom, MS

New findings from two studies have tied use of the antiviral drug nirmatrelvir-ritonavir (Paxlovid) to a reduction in COVID-19 hospitalizations and death, as well as to faster resolution of symptoms and less use of healthcare resources.

Benefit seen only in older patients For the first study, published in Clinical Microbiology and Infection, a Medical University of Vienna–led research team compared the effectiveness of Paxlovid with that of the antiviral drug molnupiravir (Lagevrio)—and with that of not receiving an antiviral—against hospitalization and all-cause death from January 2022 to May 2023. Participants were adults with mild to moderate infections and one or more risk factors for severe illness caused by the SARS-CoV-2 Omicron variant.

"The oral antivirals nirmatrelvir-ritonavir and molnupiravir are the mainstay treatment for Covid-19 in non-hospitalised adults at increased risk of severe disease," the study authors wrote. "Both oral antivirals were approved at the time of the study period (2022/2023) for the treatment of non-hospitalised patients with mild-to-moderate Covid-19, but the current National Institute of Health guidelines favour nirmatrelvir-ritonavir over molnupiravir."

Of the 113,399 eligible COVID-19 patients in the retrospective cohort study, 10.7% received Paxlovid, 9.5% received molnupiravir, and 80.0% served as untreated controls. Over 96% of participants were previously infected with or vaccinated against COVID-19.

A total of 0.43% of Paxlovid recipients, 1.4% of molnupiravir users, and 1.13% of controls were hospitalized within 28 days (risk difference [RD], -0.7%; Paxlovid vs control RD, 0.26%). No Paxlovid recipients and 0.13% each of molnupiravir users and controls died.

The estimated risk of hospitalization was 0.57% in Paxlovid users and 1.09% in controls (adjusted RD [aRD], -0.53%). The estimated risk of death was 0.0% in the Paxlovid group and 0.13% in controls (aRD, -0.13%).

The number of patients needed to treat to prevent hospitalization and death was 190 in Paxlovid recipients and 792 in controls, respectively. These statistically significant aRDs were seen only among patients 60 years and older.

The estimated risk of hospitalization in the molnupiravir analysis was 1.36% in the molnupiravir group and 1.16% among controls (aRD, 0.2%). The estimated risk of death was 0.12% in molnupiravir recipients and 0.14% in controls (aRD, -0.01%).

"Among outpatients aged ≥60 years with Covid-19 in an Omicron-dominated era, treatment with nirmatrelvir-ritonavir was associated with a lower risk of hospitalisation and all-cause death within 28 days, albeit with wide confidence intervals and high numbers needed to treat," the study authors wrote.

"This finding was not observed in molnupiravir users and younger nirmatrelvir-ritonavir users. Future studies are needed to better define target populations that show greater benefit from treatment with nirmatrelvir-ritonavir," they concluded.

Proportion of patients seeking care slashed 73% The second study, a phase 2/3 randomized clinical trial published today in Clinical Infectious Diseases, also found protection against COVID-19 hospitalization and death in adults receiving Paxlovid and demonstrated a faster resolution of symptoms and lower use of healthcare resources compared with a placebo in high-risk patients.

The research was led by researchers from Pfizer, which developed Paxlovid. The drug was given to 977 symptomatic COVID-19 patients, while 989 were given a placebo, at 343 sites in 21 countries from July 2021 through December 2021, a Delta-predominant period.

Paxlovid significantly shortened the time to symptom relief (median, 13 vs 15 days; hazard ratio, 1.27) and resolution (16 vs 19 days; HR, 1.20) through 28 days and cut the number of COVID-related medical visits by 64.3% and the proportion of patients seeking care by 73.2%.

In total, 0.9% of Paxlovid recipients and 6.4% in the placebo group were hospitalized, for a relative risk reduction of 85.5%. Hospitalized Paxlovid recipients had briefer hospital stays, and none required intensive care or mechanical ventilation. Fewer patients in the Paxlovid group needed other COVID-19 treatments, and none died by 6 months, compared with 15 in the placebo group.

"The importance of having effective COVID-19 treatments such as NMV/r [Paxlovid] to reduce burden on healthcare systems, both ambulatory and hospital based, should not be underestimated," the authors wrote.

Study Links: www.clinicalmicrobiologyandinfection.com/article/S1198-743X(24)00508-1/fulltext

academic.oup.com/cid/advance-article/doi/10.1093/cid/ciae551/7889107

[samwiselastname]

ONE THIRD RITONAVIR TWO THIRDS NIRMATRELVIR

FROM A PHARMACIST OR WHATEVER

MOUTH TASTES BAD, MAKES YOU POOP

LUNGS EXPEL ALL THEIR GOOP

PAXLOVID FOR WHEN YOU'RE SICK

ANTIVIRALS DO THE TRICK

[the-un-named-gallery]

Nirmatrelvir / Ritonavir

The taste that remains Even hours after Is a basement Dug out in the early nineteens That old house on Jefferson in Nordeast No more than 4 could stand Together in the same place At the same time The walls the walls Were bowed and Crumbling in a cakey crunch Bowing inward Being pushed in from the ground With-out. Pipes run overhead. Covered in years of paint Attempting to cover the years of rusty coats. This concrete floor, Permanently un-swept Every object, Toolbox, Paint can, Cardboard box, Objects Covered in Toxic coffee crumb cake And nuts-and-bolts brittle. These rickety stairs And low-hanging Beams will never Politely ask anything Of you. Further in, The so-called crawl space, Not fit for crawling Only for waking in the Dark not knowing and Hoping you were somewhere else. This single light bulb and that dust in your eyes. That's what it tastes like. 4.11.24

[quaranmine]

playing doctor on myself this morning with google and losing my mind just a bit

i keep. over the course of the last two years at least. randomly getting these blotchy red rashes on my torso. they don't itch or hurt, they aren't raised, and they seem completely random. i cannot figure it out or any link between it appearing. It will typically last several hours. they do not go on my face, neck, or limbs, just the torso. i don't think theyre like dangerous??? because i assume that if they were i would have some adverse reaction like pain, fever, swelling, etc. so that is why i have not been overly concerned with it. but it is baffling me. now sometimes in the past i have gotten extremely itchy for no reason on my torso, so maybe that's a factor, but the itchiness does not always coincide with the rash. for example, today there is none.

the thing i'm interested in today though, is if it's some sort of drug allergy rash. because it always looks exactly like the rash i got last year when i took paxlovid for my covid infection. the doctor told me that's a common (harmless) reaction. i've looked it up and it looks most like a morbilliform drug reaction which are very common. so, if morbilliform drug reactions look and behave like that, i had that reaction to taking a drug, and a doctor told me it was a reaction to the drug then....

...it stands to reason that my experiencing this off and on for 2-3 years might ALSO be a similiar reaction? i just can't figure out the common thread.

one of my meds is implicated as a cause for this type of rash, and has studies/journal articles on it causing this. EXCEPT. um, it happens when you are first introduced to taking it??? and like dude i've been taking this particular medication since 2016 probably. i'm sure anything is possible (like developing new sensitivies) but nothing i have read is about reactions popping up YEARS after the fact, just within 1-3 weeks of starting it. i saw a study done on someone who developed the rash after taking the medicine, but 5 days after first taking it. i saw another study/journal article that was written as a diagnostic aid that literally excluded any drugs you'd been on for a few months as not the cause. so??? idk. my other medicine does not seem to be implicated in this, as when i looked it up i didn't really get anything.

i'm no biochemist or whatever but i can't seem to find any similarities between my med and paxlovid? like ok, we've established that either the nirmatrelvir or ritonavir that is in paxlovid likely caused it. that's what the doctor said. he said my reaction was a common one to one of the drugs in that mixture, which lines up with everything i have read. but afaik these drugs arent like....similiar to the one i have been taking...it isnt like "oh these are the same drug class so maybe your issue is with them"....

the other (relevant) drug implicated in these types of reactions are NSAIDS. now this could be something. i did take ibuprofen yesterday, and woke up with the reaction. is that it? i'm going to start logging it every time it happens to see if it ever coincides with me recently taking ibuprofen. BUT LIKE. i take ibuprofen pretty frequently, mostly for headaches. this reaction might only happen once every two or three months. i feel like if i were getting a reaction from ibuprofen it would happen every time, not just once in a blue moon?

so why am i experiencing it today???? i'm not wearing any clothing made from atypical materials. i havent used any new shower products. i havent tried any new medicines for a while. i havent eaten anything i don't normally have. none, except for the paxlovid rash, coincide with me being sick so i doubt it's viral.

if it IS a mobilliform drug reaction, it still seems atypical because a) i havent started anything new b) it goes away within a few hours, not days/weeks c) it isn't always itchy

WHERE IS THE COMMON LINK AND HOW DO I FREE MYSELF OF THIS?

[impulsivelycontentious]

Unfortunately the effectiveness of paxlovid is waining FAST.

https://www.webmd.com/covid/news/20230922/paxlovid-weaker-against-current-covid-variants

It can still help with severe acute patients and some high risk patients but already shows no difference for people not in at-risk groups who are also vaccinated. It's effectiveness on the vaccinated population is much reduced (still helpful if you're high risk).

https://www.medscape.com/viewarticle/study-shows-nirmatrelvir-ritonavir-no-more-effective-than-2024a10006gb

My last bout of covid came with a warning about the reduced effectiveness. I wish I'd seen this about the cost like... 11 days ago. I was bounced in to the hospital again but it wasn't worth it at full price. I would have used it to protect my heart from further damage if i'd known I could get it, but you will find health care professionals rightfully warning you that it's not as good as it used to be.

So, be aware, it can still help the at risk and vaccinated but it's not gonna be easy.

Opinion Here’s how to get free Paxlovid as many times as you need it

When the public health emergency around covid-19 ended, vaccines and treatments became commercial products, meaning companies could charge for them as they do other pharmaceuticals. Paxlovid, the highly effective antiviral pill that can prevent covid from becoming severe, now has a list price of nearly $1,400 for a five-day treatment course.

Thanks to an innovative agreement between the Biden administration and the drug’s manufacturer, Pfizer, Americans can still access the medication free or at very low cost through a program called Paxcess. The problem is that too few people — including pharmacists — are aware of it.

I learned of Paxcess only after readers wrote that pharmacies were charging them hundreds of dollars — or even the full list price — to fill their Paxlovid prescription. This shouldn’t be happening. A representative from Pfizer, which runs the program, explained to me that patients on Medicare and Medicaid or who are uninsured should get free Paxlovid. They need to sign up by going to paxlovid.iassist.com or by calling 877-219-7225. “We wanted to make enrollment as easy and as quick as possible,” the representative said.

Indeed, the process is straightforward. I clicked through the web form myself, and there are only three sets of information required. Patients first enter their name, date of birth and address. They then input their prescriber’s name and address and select their insurance type.

All this should take less than five minutes and can be done at home or at the pharmacy. A physician or pharmacist can fill it out on behalf of the patient, too. Importantly, this form does not ask for medical history, proof of a positive coronavirus test, income verification, citizenship status or other potentially sensitive and time-consuming information.

But there is one key requirement people need to be aware of: Patients must have a prescription for Paxlovid to start the enrollment process. It is not possible to pre-enroll. (Though, in a sense, people on Medicare or Medicaid are already pre-enrolled.)

Once the questionnaire is complete, the website generates a voucher within seconds. People can print it or email it themselves, and then they can exchange it for a free course of Paxlovid at most pharmacies.

Pfizer’s representative tells me that more than 57,000 pharmacies are contracted to participate in this program, including major chain drugstores such as CVS and Walgreens and large retail chains such as Walmart, Kroger and Costco. For those unable to go in person, a mail-order option is available, too.

The program works a little differently for patients with commercial insurance. Some insurance plans already cover Paxlovid without a co-pay. Anyone who is told there will be a charge should sign up for Paxcess, which would further bring down their co-pay and might even cover the entire cost.

Several readers have attested that Paxcess’s process was fast and seamless. I was also glad to learn that there is basically no limit to the number of times someone could use it. A person who contracts the coronavirus three times in a year could access Paxlovid free or at low cost each time.

Unfortunately, readers informed me of one major glitch: Though the Paxcess voucher is honored when presented, some pharmacies are not offering the program proactively. As a result, many patients are still being charged high co-pays even if they could have gotten the medication at no cost.

This is incredibly frustrating. However, after interviewing multiple people involved in the process, including representatives of major pharmacy chains and Biden administration officials, I believe everyone is sincere in trying to make things right. As we saw in the early days of the coronavirus vaccine rollout, it’s hard to get a new program off the ground. Policies that look good on paper run into multiple barriers during implementation.

Those involved are actively identifying and addressing these problems. For instance, a Walgreens representative explained to me that in addition to educating pharmacists and pharmacy techs about the program, the company learned it also had to make system changes to account for a different workflow. Normally, when pharmacists process a prescription, they inform patients of the co-pay and dispense the medication. But with Paxlovid, the system needs to stop them if there is a co-pay, so they can prompt patients to sign up for Paxcess.

Here is where patients and consumers must take a proactive role. That might not feel fair; after all, if someone is ill, people expect that the system will work to help them. But that’s not our reality. While pharmacies work to fix their system glitches, patients need to be their own best advocates. That means signing up for Paxcess as soon as they receive a Paxlovid prescription and helping spread the word so that others can get the antiviral at little or no cost, too.

{source}

[biotech-news-feed]

Opinion/decision on a Paediatric investigation plan (PIP): Paxlovid, nirmatrelvir,nirmatrelvir / ritonavir, decision type: PM: decision on the application for modification of an agreed PIP, therapeutic area: Infectious diseases, PIP number: P/0447/2 #BioTech #science

[gregmh-blog]

Why arent people using Paxlovid?

Why aren’t people using Paxlovid? https://ift.tt/myJ9iAe Paxlovid (nirmatrelvir-ritonavir) is effective at preventing hospitalization and death from COVID-19, but few people use it. A paper by SteelFisher et al. (2024) surveyed 1,430 American adults to find out why. Their survey revealed patients had a lack of awareness of the treatment as well as misinformation about the treatment (among those who were aware of it). Specifically: A majority of respondents (85 percent) had no or low awareness of Paxlovid, including 31 percent who had never heard of it. Even among those who were aware of the drug, many held misperceptions about its effectiveness (39 percent), adverse effects (86 percent), and requisite timing (61 percent) that could lead to underuse. Lower awareness and misperceptions were more common among medically vulnerable and disadvantaged populations who might benefit most from Paxlovid access, including adults unvaccinated against COVID-19, those with lower levels of education, and Black and Hispanic or Latino adults. https://ift.tt/NqrWc3z You can read the full paper here. via Healthcare Economist https://ift.tt/d40H1Pz October 01, 2024 at 01:55AM

[healthcare7463]

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Indian Brand Name Nirmatrelvir Tablets and Ritonavir Tablets:

Drug Type: Generic

Composition: Nirmatrelvir Tablets and Ritonavir Tablets.

Physical form: tablet

Recommended for: COVID-19 treatment

Medication Guidelines: As recommended by a physician.

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[covid-safer-hotties]

Also preserved in our archive (Daily updates!)

by Dr. Monica M. Bertagnolli

In 2021, NIH launched the Researching COVID to Enhance Recovery (RECOVER) Initiative , a nationwide research program, to fully understand, diagnose, and treat Long COVID. We continue to learn more about this condition, in which some people experience a variety of symptoms for weeks, months, or even years after infection with SARS-CoV-2, the virus that causes COVID-19. But we’re still working to understand the underlying reasons why people develop Long COVID, who is most likely to get it, and how best to treat or prevent it.

Studies have shown that for some people, SARS-CoV-2 doesn’t completely clear out after acute infection. Scientists have observed signs that the virus may persist in various parts of the body, and many suspect that this lingering virus, or remnants consisting of SARS-CoV-2 protein, may be causing Long COVID symptoms in some individuals. Now, in a new study supported by RECOVER, scientists found that people with Long COVID were twice as likely to have these viral remnants in their blood as people with no lingering symptoms. The findings, reported in Clinical Microbiology and Infection , add to evidence that Long COVID may sometimes stem from persistent infection or SARS-CoV-2 protein remnants.

The study team, led by David Walt and Zoe Swank at Brigham and Women’s Hospital in Boston, had earlier found preliminary evidence in a small pilot study that a SARS-CoV-2 protein could often be detected in the bloodstreams of people with Long COVID up to a year after the initial infection. In the new study, they wanted to better quantify this in a much larger group of people with Long COVID. The researchers developed a highly sensitive test to look for whole and partial proteins from the SARS-CoV-2 virus. They analyzed 1,569 blood samples collected from 706 people at various times after SARS-CoV-2 infection.

Overall, 21% of those in the study had detectable levels of a SARS-CoV-2 protein between 4 and 7 months after infection. In total, 82% of the study’s participants (578 people) had at least one symptom of Long COVID more than a month after their infections. Commonly reported symptoms included fatigue, brain fog, muscle pain, joint pain, back pain, headache, sleep disturbance, loss of smell or taste, and gastrointestinal symptoms. More than half of participants in this group (378 people) reported experiencing ongoing cardiopulmonary, musculoskeletal, or neurologic symptoms, and among those participants, 43% (165 people) had detectable virus protein. Also of note, of the asymptomatic people, about 20% had detectable virus protein.

While the researchers can’t definitively show that persistent infections are the cause of some Long COVID symptoms, the findings add to growing evidence that low levels of viral protein being present may explain some but not all cases of Long COVID. The authors and many other researchers suspect that Long COVID likely has multiple underlying causes. For instance, it’s possible that the virus may lead to harmful changes in the immune system that play a role in some cases of Long COVID.

Scientists also want to see if there is a subset of people with Long COVID or persistent symptoms who may benefit from antiviral treatment. To this end, RECOVER is supporting a clinical trial evaluating whether the antiviral drug Paxlovid (a combination of nirmatrelvir and ritonavir), which is used to treat COVID-19, could also be used to improve Long COVID symptoms. The trial is using the SARS-CoV-2 blood test developed by the Brigham and Women’s study team to evaluate whether Paxlovid can eliminate viral proteins from participants’ blood.

More study is needed to understand the causes of Long COVID symptoms in people who test negative for persistent infection, the researchers note. They are conducting follow-up studies in even more people with Long COVID, including those with compromised immune systems. They hope to learn more about what causes some people to be at higher risk for retaining some SARS-CoV-2 protein remnants and Long COVID.

Reference:

Swank Z, et al; RECOVER consortium authors. Measurement of circulating viral antigens post-SARS-CoV-2 infection in a multicohort study. Clinical Microbiology and Infection. DOI: 10.1016/j.cmi.2024.09.001 (2024).

Study Link: www.sciencedirect.com/science/article/abs/pii/S1198743X24004324?via%3Dihub (PAYWALLED)

[themikecollective]

if you haven't tried the manufacturer's coupon - https://www.paxlovid.com/enroll-in-co-pay-program

unfortunately your favorite tumblr user (me) has caught covid 19

you may all begin weeping

[puravibenamastes-blog]

Paxlovid, remédio para tratar Covid, está subutilizado no SUS

O Paxlovid (junção dos anvirais nirmatrelvir e ritonavir), indicado para tratamento da Covid leve em adultos, está subutilizado no país. É o que mostram os números obtidos via LAI (Lei de Acesso à Informação) pela Fiquem Sabendo -organização sem fins lucrativos especializada em transparência pública. Leia mais (03/22/2024 – 16h00) Artigo Folha de S.Paulo – Equilíbrio e Saúde – Principal Pulicado…

[tommyysscott]

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