First Efficacy Study of Investigational Antiviral Therapy for COVID-19 Infection in Patients with IBD
In a new study, Mayo Clinic in Florida researchers and collaborators have found that the antiviral medication Paxlovid reduces the risk of hospitalization in patients with inflammatory bowel disease (IBD) who become infected with COVID-19, compared to patients with IBD who did not receive this medication. The findings were published in the journal Clinical Gastroenterology and Hepatology. This study is the first to show data on the use of antivirals for the treatment of COVID-19 in patients with IBD.
IBD encompasses a range of disorders involving inflammation of the digestive tract, including ulcerative colitis and Crohn's disease. Symptoms for both conditions can include diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss.
The researchers aimed to compare outcomes of patients with IBD who received antivirals for COVID-19 with those who didn't, and with non-IBD patients who received them. The retrospective study was conducted with technology providing real-time access to de-identified electronic health records of 78 million people. The researchers analyzed data for patients who took either nirmatrelvir/ritonavir (Paxlovid) or molnupiravir (Lagevrio) for COVID-19. The Food and Drug Administration has made both drugs available under an emergency use authorization.
In a group of nearly 30,000 patients with IBD who had a COVID-19 infection, 538 received Paxlovid. None of them required hospitalization, while 5% of the patients not receiving this medication were hospitalized. No patient receiving Paxlovid died, but as many as 1.8% of patients not on this medication in the study group died. The researchers found no reduction in hospitalization in a small group of patients who received molnupiravir. They also found no difference between patients with IBD and those without the condition who received these drugs for COVID-19, which they say indicates no decreased efficacy of the drugs in patients with IBD.
"The research suggests use of the antiviral study drug in patients with IBD at high risk of developing complications with a COVID-19 infection, as it may reduce the risk of hospitalization and death," says Jana Al Hashash, M.D., a gastroenterologist at Mayo Clinic in Florida, and first author on the paper.
The study was conducted in collaboration with researchers from MetroHealth Medical Center, Cleveland, OH; Case Western Reserve University, Cleveland, OH; and Allegheny Health Network, Pittsburgh, PA.
For the complete study results, author list, disclosure information and funding, see the published paper.
—Lynda de Widt