Trial reportThe New England journal of medicine2022
Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19.
Trial report in The New England journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 1,289 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
An interventional efficacy and safety, phase 2/3, double-blind, 2-arm study to investigate orally administered pf-07321332/ritonavir compared with placebo in nonhospitalized symptomatic adult participants with covid-19 who are at increased risk of progressing to severe illness
An Interventional Efficacy and Safety, Phase 2, Double-blind, 3-arm Study to Investigate Orally Administered High/Low-dose Cepharanthine Compared With Placebo in Nonhospitalized Asymptomatic or Mild Adult Participants With COVID-19
An Interventional, Double-Blinded, 2-Arm Study to Investigate the Efficacy of Orally Administered Nirmatrelvir/Ritonavir Compared with Placebo/Ritonavir in Non-hospitalized Adult Participants Suffering from Post-COVID
PAxlovid loNg cOvid-19 pRevention triAl With recruitMent In the Community in Norway
A Randomized, Double-blind, Placebo-controled, Phase 2a Trial Evaluating the Safety and Initial Efficacy of Resomelagon in Patients With Dengue Infection
Who cites it
1,289 citing papers in PubMed, 7 syntheses or guidelines pooled it, 2,119 citations in OpenAlex.
- Effectiveness of Nirmatrelvir/Ritonavir for Outpatients in the Era of Omicron, Vaccination, and Previous Infection: A Meta-analysis.Journal of general internal medicine · 2026Pooled it
- Clinical practice guideline for long COVID prevention and treatment.The European respiratory journal · 2026Guideline
- Real-world untreated risk of hospitalization and death in a nirmatrelvir/ritonavir treatment-eligible population with mild-to-moderate COVID-19 in the United States: a systematic literature review.BMC infectious diseases · 2026Pooled it
- Guideline
- Pooled it
- Drug treatments for mild or moderate covid-19: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Evaluating the safety and efficacy of nirmatrelvir-ritonavir therapy in pregnant women with COVID-19: a systematic review and meta-analysis.European journal of clinical pharmacology · 2025Pooled it
- Pharmacokinetics, safety, and dose optimization of GST-HG171 in renal impairment: insights from physiologically based pharmacokinetic modeling.Antimicrobial agents and chemotherapy · 2026Trial
- Effect of inhaled interferon-β1a on SARS-CoV-2 diversity and evolution.Microbiology spectrum · 2026Trial
- Cytomegalovirus DNAemia in Hospitalized Adults With SARS-CoV-2 Infection Requiring Supplemental Oxygen: Virologic and Clinical Characteristics and Association With Outcomes.The Journal of infectious diseases · 2026Trial
- Oral Nirmatrelvir-Ritonavir for Covid-19 in Higher-Risk Outpatients.The New England journal of medicine · 2026Trial
- Health-related quality of life in immunocompromised adults with mild-moderate COVID-19 treated with nirmatrelvir-ritonavir: results from the randomized, double-blinded EPIC-IC trial.Health and quality of life outcomes · 2026Trial
- A bidimensional early intervention strategy of standard of care in combination with corticosteroids in elderly patients with mild to moderate COVID-19 (BEAT-COV study): a multicentre, open-label, randomized controlled trial.BMC infectious diseases · 2026Trial
- Bayesian reanalysis of early remdesivir for the treatment of COVID-19 in outpatients with high risk of progression to severe disease.PloS one · 2026Trial
- Molnupiravir or nirmatrelvir-ritonavir plus usual care versus usual care alone in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.The Lancet. Infectious diseases · 2025Trial
- Metformin and Time to Sustained Recovery in Adults With COVID-19: The ACTIV-6 Randomized Clinical Trial.JAMA internal medicine · 2025Trial
- CT changes in a randomized trial comparing early therapies in an outpatient population at high risk of severe COVID19 disease.Scientific reports · 2025Trial
- Assessing participants' experiences with the COVID-19 symptom diary in a clinical trial.Journal of patient-reported outcomes · 2025Trial
- Integrated virologic analysis of resistance to nirmatrelvir/ritonavir in individuals across four phase 2/3 clinical studies for the treatment of COVID-19.EBioMedicine · 2025Trial
- Effects of Baloxavir Marboxil Plus Neuraminidase Inhibitor vs Neuraminidase Inhibitor in High-risk Patients Hospitalized With Severe Influenza: A Post Hoc Analysis of the Flagstone Trial.Open forum infectious diseases · 2025Trial
1,229 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNirmatrelvir is an orally administered severe acute respiratory syndrome coronavirus 2 main protease (M
methodsWe conducted a phase 2-3 double-blind, randomized, controlled trial in which symptomatic, unvaccinated, nonhospitalized adults at high risk for progression to severe coronavirus disease 2019 (Covid-19) were assigned in a 1:1 ratio to receive either 300 mg of nirmatrelvir plus 100 mg of ritonavir (a pharmacokinetic enhancer) or placebo every 12 hours for 5 days. Covid-19-related hospitalization or death from any cause through day 28, viral load, and safety were evaluated.
resultsA total of 2246 patients underwent randomization; 1120 patients received nirmatrelvir plus ritonavir (nirmatrelvir group) and 1126 received placebo (placebo group). In the planned interim analysis of patients treated within 3 days after symptom onset (modified intention-to treat population, comprising 774 of the 1361 patients in the full analysis population), the incidence of Covid-19-related hospitalization or death by day 28 was lower in the nirmatrelvir group than in the placebo group by 6.32 percentage points (95% confidence interval [CI], -9.04 to -3.59; P<0.001; relative risk reduction, 89.1%); the incidence was 0.77% (3 of 389 patients) in the nirmatrelvir group, with 0 deaths, as compared with 7.01% (27 of 385 patients) in the placebo group, with 7 deaths. Efficacy was maintained in the final analysis involving the 1379 patients in the modified intention-to-treat population, with a difference of -5.81 percentage points (95% CI, -7.78 to -3.84; P<0.001; relative risk reduction, 88.9%). All 13 deaths occurred in the placebo group. The viral load was lower with nirmatrelvir plus ritonavir than with placebo at day 5 of treatment, with an adjusted mean difference of -0.868 log
conclusionsTreatment of symptomatic Covid-19 with nirmatrelvir plus ritonavir resulted in a risk of progression to severe Covid-19 that was 89% lower than the risk with placebo, without evident safety concerns. (Supported by Pfizer; ClinicalTrials.gov number, NCT04960202.).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.