from the New England Journal of Medicine
There’s new hope for the average person seeking relief from COVID-19: a drug called simnotrelvir has been shown to speed recovery from mild to moderate disease by about 1.5 days1.
The ongoing coronavirus disease 2019 (Covid-19) pandemic continues to inflict an important burden on global health and health care systems worldwide.1 Vaccination can lessen the effect of the disease in high-risk groups but is less effective in preventing infections caused by emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with strong immune evasion.2,3 Effective antiviral agents are needed for the treatment of SARS-CoV-2 infections. Several small-molecule drugs (e.g., nirmatrelvir4 and ensitrelvir5) targeting the SARS-CoV-2 3-chymotrypsin–like cysteine protease enzyme (3CLpro, also known as main protease [Mpro]) are available. However, because of the high costs of the drugs and inequity in their distribution, more drug options are needed to accelerate the resolution of symptoms among patients with mild-to-moderate Covid-19.
Early in the pandemic, antiviral drugs were tested largely in people at high risk of severe COVID-19. Even now, the World Health Organization recommends that only people in high-risk groups take antivirals such as Paxlovid, the go-to COVID-19 pill in the United States and many other nations. The researchers combined simnotrelvir with a component of Paxlovid called ritonavir, which limits the breakdown of simnotrelvir. They tested this combination in more than 600 people with a median age of 35, around half of whom had at least one risk factor, such as obesity, for severe disease. None of the participants had severe COVID-19.
By the fifth day after treatment, SARS-CoV-2 levels in participants who’d taken simontrelvir had dropped by about 30-fold more than in participants who’d taken a placebo. Simnotrelvir’s ability to speed recovery in standard-risk people is reminiscent of the antiviral ensitrelvir, which was approved conditionally in Japan in November 2022.
The downsides of simontrelvir are similar to those of Paxlovid, including a notoriously bad taste and incompatibility with a range of common medications. In addition, the researchers asked trial participants to start treatment within three days of developing symptoms: a “challenging window for testing and intervention”
For those of you with mild COVID simnotrelvir offers some relief.