Molnupiravir does not appear to reduce deaths or hospitalisation in high-risk vaccinated adults with COVID-19 compared with usual care, according to the largest randomised trial of the agent to date.  

The oral antiviral (Lagevrio) has been a key part of Australia’s recent defence in the pandemic, with more than 237,000 scripts dispensed.

However, preliminary findings from a University of Oxford open-label randomised controlled trial, published without peer review on a preprint server last week, found that molnupiravir was not associated with statistically significant superiority in preventing hospital admission or death than usual care.

The trial, dubbed PANORAMIC, involved some 25,780 UK adults aged 50 and older or over-18s with comorbidities (mean age 57) who had confirmed COVID-19. They were randomised to receive molnupiravir 800mg twice daily for five days or usual care, which included monoclonal antibodies or other antivirals.