Covid-19 Group 3 Patients Neutralising Monoclonal Antibodies (nMabs) for Non-Hospitalised patients (974)


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Antiviral treatments inhibit the development and replication of viruses such as SARS-CoV-2. Neutralising monoclonal antibodies (nMAB) bind to specific sites on the spike protein of the SARS- CoV-2 virus particle, blocking its entry into cells and therefore inhibiting its replication.

Recent evidence suggests that nMABs and oral antivirals significantly improve clinical outcomes in non-hospitalised patients with COVID-19 who are at high risk of progression to severe disease and/or death. Key findings are as follows:

  • PaxlovidTM (c (nirmatrelvir) plus ritonavir)- administered orally as dual antiviral treatment in the

    EPIC HR trial resulted in a relative risk reduction of hospitalisation or death by 89% (within 3 days of symptom onset) and 88% (within 5 days of symptom onset) compared to placebo in non- hospitalised, high-risk adults with COVID-19. (Pfizer press release).

  • Sotrovimab administered intravenously to non-hospitalised patients with mild-to-moderate disease and at least one risk factor for disease progression resulted in a relative risk reduction in hospitalisation or death at day 29 by 85% in the interim analysis of the COMET-ICE trial (Gupta et al, 2021a). Final analysis of this trial shows a relative risk reduction of 79% (Gupta et al, 2021b).

  • Final results from the Phase 3 MOVe-OUT trial show that the oral antiviral molnupiravir resulted in a relative risk reduction of 30% in the composite primary outcome of hospitalisation or death at day 29 (6.8% in the molnupiravir group vs 9.7% in the placebo group, p=0.0218) (Bernal et al, 2021).


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Acute / All Inpatient
Board Wide
Medicines / Pharmacy

Last reviewed: 16 February 2022

Next review: 24 February 2023

Author(s): Samantha Campbell

Version: 3

Author Email(s): [email protected]

Approved By: Covid-19 Tactical Group (Acute)

Document Id: 974