Episode 314: 313. Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19
Questioning Medicine5 Heinä 2024

Episode 314: 313. Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19

https://pubmed.ncbi.nlm.nih.gov/38598573/

In fully vaccinated adults with a risk factor or unvaccinated patients without a risk factor who have symptomatic COVID-19, does paxlovid--nirmatrelvir-ritonavir reduce the duration of symptoms or the likelihood of hospitalization?

Nirmatrelvir-ritonavir (Paxlovid) was shown in its initial randomized trial to reduce hospitalization and death in unvaccinated adults with at least one risk factor for severe disease when the ancestral variant of SARS-CoV-2 was predominant.

But it is important that drugs be evaluated in the correct target population patients who have been vaccinated or have the Omicron variant.

This industry-sponsored study enrolled 2 groups of patients: (1) fully vaccinated adults with symptomatic, confirmed infection with SARS-CoV-2 and at least one risk factor for severe disease,

(2) unvaccinated adults with a symptomatic infection but no risk factors

The onset of symptoms was within the past 5 days. Patients (N = 1296) were randomized to receive the standard 5-day course of nirmatrelvir-ritonavir or matching placebo.

the 1440 participants who were initially randomized There was no difference in duration of symptoms between groups, and no significant difference in the likelihood of hospitalization or death (0.8% vs 1.6% for placebo; difference -0.8%; 95% CI -2.0 to 0.4).

Jaksot(385)

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

https://www.jthjournal.org/article/S1538-7836(25)00109-6/fulltextAntithrombotic agents, like aspirin and anticoagulants, are essential for treating many cardiovascular conditions. However, a common si...

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Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

https://jamanetwork.com/journals/jama/article-abstract/2834632SummaryThe article examines the effectiveness and safety of zilebesiran, an RNA interference therapeutic agent, when used in combination w...

4 Kesä 20258min

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

https://www.nejm.org/doi/full/10.1056/NEJMoa2405182?query=recirc_Semantic  Key Takeaways Extended Predictive Value of Biomarkers: High-sensitivity C-reactive protein (CRP), LDL cholesterol, and lipop...

29 Touko 20259min

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Desgagnés N et al. Use of albumin-adjusted calcium measurements in clinical practice. JAMA Netw Open 2025 Jan 21; 8:e2455251. (https://doi.org/10.1001/jamanetworkopen.2024.55251)Overall, total calcium...

27 Touko 20257min

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

https://www.nejm.org/doi/10.1056/NEJMoa2416394At 72 weeks, the mean percentage decrease in weight was significantly greater with tirzepatide than with semaglutide (20% vs. 14%). Gastrointestinal side ...

21 Touko 20258min

Episode 386: 397. What is the new drug for smoking cessation?

Episode 386: 397. What is the new drug for smoking cessation?

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832701In this multisite trial, 800 adults who smoked 10 or more cigarettes daily (mean duration of smoking, ≈35 years) were randomize...

9 Touko 20255min

Episode 385: 396. Vitamin D and Kids (CME)

Episode 385: 396. Vitamin D and Kids (CME)

What does the evidence and the guidelines say about the use and testing of Vitamin D in kids

7 Touko 20258min

Episode 384: 395. How accurate is the BMI?

Episode 384: 395. How accurate is the BMI?

Aryee EK et al. Prevalence of obesity with and without confirmation of excess adiposity among US adults. JAMA 2025 Apr 17; [e-pub]. (https://doi.org/10.1001/jama.2025.2704)The rate of obesity was 39.7...

6 Touko 20255min

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