Evidence map›Paper›PMID 40825809›Full record

Trial reportScientific reports2025

CT changes in a randomized trial comparing early therapies in an outpatient population at high risk of severe COVID19 disease.

Ilaria Mastrorosa, Alessandro Cozzi-Lepri, Giulia Matusali, Francesca Colavita, Simone Lanini, Martina Rueca, Alessandra Oliva, Giulia Berno, Alessandra Vergori, Silvia Rosati and 7 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Ilaria MastrorosaClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Alessandro Cozzi-LepriCentre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health UCL, London, UK. a.cozzi-lepri@ucl.ac.uk.
Giulia MatusaliLaboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Francesca ColavitaClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Simone LaniniClinic Infectious Diseases, University of Udine, Udine, Italy.
Martina RuecaLaboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Alessandra OlivaClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Giulia BernoLaboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Alessandra VergoriClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Silvia RosatiClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Jessica PaulicelliClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Enrico GirardiScientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Emanuele NicastriClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Fabrizio MaggiLaboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Andrea AntinoriClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
Valentina MazzottaClinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
MONET Clinical Trial Group

Funding

HORIZON EUROPE Framework Programme 101046016Italian Drug Agency (AIFA) and by the Italian Ministry of Health Ricerca Corrente Linea 1
6 · The paper itself

Abstract

Although in vitro studies suggest that neutralization by monoclonal antibodies (mAbs) against SARS CoV2 Omicron sub lineages is reduced, in vivo virological response data are lacking. MONET (EudraCT: 2021-004188-28) was multi-centric phase 4 open-label parallel randomized clinical trial, conducted in Italy over 2022-2023, to assess the efficacy of sotrovimab (SOT), tixagevimab/cilgavimab (TIX/CIL) and Nirmatrelvir/ritonavir (NMV/r), in outpatients at high risk for severe COVID-19. The outcome (secondary in the trial protocol) was SARS-CoV-2 variation in cycle threshold (CT) values over the first 7 days (D1-D7) of the trial. CT variation was compared by trial arms using unadjusted linear regression and after controlling for age. We included 346 individuals: 116 (34%) received SOT, 113 (33%) TIX/CIL, 117 (34%) NMV/r. Main characteristics were balanced across arms. Most of the participants were infected with BA.2 (52%) or BA.4/5 (35.5%). The data carried strong evidence that the mean CT change over D1-D7 was larger in subjects receiving NMV/r vs. the other arms (p < 0.001). We found no evidence that viral variant was an effect measure modifier for the contrasts of interest (p = 0.14). Our analysis provides strong evidence that NMV/r exerts a greater in vivo antiviral effect than anti-Spike mAbs against Omicron sub lineages, confirming previous in vitro data.

Indexed as

Antiviral AgentsCOVID-19COVID-19 Drug TreatmentSARS-CoV-2AdultAgedAntibodies, Monoclonal, HumanizedFemaleHumansItalyMaleMiddle AgedOutpatientsRitonavirTomography, X-Ray ComputedTreatment OutcomeAntibodies, Monoclonal, HumanizedAntiviral AgentsRitonavirAntibodies responseAntiviral agentsCT valueInflammatory markersMonoclonal antibodiesRCTSARS coronavirus

Identifiers

PMID40825809
PMCPMC12361421

What OpenQuestion holds

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Registered trials

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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.