https://doi.org/10.1016/j.apsb.2024.12.032
This new article publication from Acta Pharmaceutica Sinica B, discusses a retrospective cohort study of the efficacy and safety of oral azvudine versus nirmatrelvir/ritonavir in elderly hospitalized COVID-19 patients aged over 60 years.
Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, the authors of this article identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan–Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573–0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877–1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18−0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment.
In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.
Keywords: COVID-19; Azvudine; Paxlovid; Elderly; Comparative study; Real-world; Effectiveness; Safety
Graphical Abstract: available at https://ars.els-cdn.com/content/image/1-s2.0-S2211383524004891-ga1_lrg.jpg
This study used five analytical methods to show that azvudine has a therapeutic effect in elderly COVID-19 patients aged over 60 years.
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The Journal of the Institute of Materia Medica, the Chinese Academy of Medical Sciences and the Chinese Pharmaceutical Association.
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CiteScore: 22.4
Impact Factor: 14.8 (Top 5 journal in the category of Pharmacology and pharmacy)
JIF without self-citation: 13.9
ISSN 2211-3835
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Bo Yu, Haiyu Wang, Guangming Li, Junyi Sun, Hong Luo, Mengzhao Yang, Yanyang Zhang, Ruihan Liu, Ming Cheng, Shixi Zhang, Guotao Li, Ling Wang, Guowu Qian, Donghua Zhang, Silin Li, Quancheng Kan, Jiandong Jiang, Zhigang Ren, A retrospective cohort study of the efficacy and safety of oral azvudine versus nirmatrelvir/ritonavir in elderly hospitalized COVID-19 patients aged over 60 years, Acta Pharmaceutica Sinica B, Volume 15, Issue 3, 2025, Pages 1333-1343, ISSN 2211-3835, https://doi.org/10.1016/j.apsb.2024.12.032.
Journal
Acta Pharmaceutica Sinica B