A new study published in Scientific Reports has investigated the effectiveness and safety of azvudine compared to nirmatrelvir-ritonavir in adult patients infected with COVID-19. The research, involving 716 patients, found that azvudine demonstrated similar efficacy to nirmatrelvir-ritonavir in reducing 28-day mortality and improving clinical outcomes.
The study retrospectively analyzed data from patients treated with either nirmatrelvir-ritonavir (n=412) or azvudine (n=304). While the nirmatrelvir-ritonavir group initially presented with more severe disease, propensity score matching was used to balance baseline characteristics between the groups.
Mortality and Clinical Outcomes
The 28-day mortality rate was 6.6% in the azvudine group and 9.7% in the nirmatrelvir-ritonavir group, a difference that was not statistically significant (OR 0.65, 95% CI 0.37–1.1, P=0.14). Similarly, changes in disease severity based on a seven-category ordinal scale showed no significant difference in clinical improvement or progression between the two treatment groups.
Safety Profile
Notably, azvudine was associated with a higher rate of treatment discontinuation due to side effects (6.6%) compared to nirmatrelvir-ritonavir (0.97%, P<0.001). The most common side effects leading to azvudine discontinuation were abnormal liver function, diarrhea, and dizziness or nausea. Conversely, nirmatrelvir-ritonavir was associated with a higher incidence of decreased platelet levels within 14 days of drug initiation (17.1% vs. 8.9%, P=0.047).
Implications of the Study
These findings suggest that azvudine represents a potential alternative for COVID-19 treatment, particularly in settings where nirmatrelvir-ritonavir may be unavailable or contraindicated. However, healthcare providers should be aware of the differing safety profiles of the two drugs when making treatment decisions. Further research is warranted to explore the long-term effects and optimal use of azvudine in diverse patient populations.
