Paxlovid is intended to protect corona-positive risk patients from a severe course. Physicians appreciate the high effectiveness of the drug – but according to reports from the USA there is a rebound effect.
USA – Paxlovid is an antiviral drug designed to inhibit the multiplication of the coronavirus in the body. Anyone who has already been infected with Covid-19 can reduce the risk of a severe course by taking it. However, reports from the USA show that there is a so-called rebound effect: Some patients were positive again after a few days. Is the Paxlovid drug really the hope that many think it is?
Coronavirus: Paxlovid reduces mortality by 81 percent
One Preprint study from Israel by the research group led by Ronen Arbel certifies Paxlovid’s outstanding effectiveness in patients over 65 years of age. According to this, it reduces the risk of hospitalization due to corona disease in older people by 67 percent. The drug reduces the risk of dying from the consequences of the corona virus by 81 percent. In the younger age group, on the other hand, there were no significant benefits from taking it. The study is a prior publication that has not yet been peer-reviewed.
A clinical study by the pharmaceutical company Pfizer also shows that unvaccinated patients who were given Paxlovid were 89 percent less likely to become seriously ill than study participants who only received a placebo. The World Health Organization (WHO) also recommends the drug, citing studies with almost 3,100 patients. The risk of hospitalization was 85 percent lower in those treated with Paxlovid than in the group who received a dummy drug, according to the WHO on the effectiveness of the tablets.
Coronavirus drug Paxlovid: This is the rebound effect
Physicians use the drug Paxlovid in high-risk patients within the first five days after the onset of symptoms. The earlier the antiviral drug is used, the more effective it is. Current reports from the USA now indicate a so-called rebound effect in some patients – i.e. a corona relapse. According to this, some people who had had a five-day treatment with Paxlovid developed corona symptoms four or five days later. Some patients tested positive for corona again after treatment with the antiviral drug. The US epidemic authority speaks of a rebound between the second and eighth day after the original recovery.
The pharmaceutical company Pfizer, which sells the drug, found in a clinical study on Paxlovid that several participants recorded an increase in virus concentration between the tenth and 14th day, as reported by the Yale School of Medicine. It was noteworthy, however, that this increase was also observed in people who only received a placebo. The US disease control agency CDC published in June of this year guidelines for clinicians. It said that a brief return of symptoms in some patients is part of the natural history of a corona infection – regardless of treatment with Paxlovid.
Paxlovid rebound effect: what is the reason for the relapses?
The exact reason for the relapses is not yet clear, but there are various hypotheses. “The hypothesis is that because Paxlovid suppressed replication early in the disease, the immune system did not have a chance to recognize the full extent of the virus,” says Dr. Scott Roberts, an infectious disease specialist at Yale University.
Other experts initially assumed that there could be two different variants of the Sars-CoV-2 virus or resistance to Paxlovid. However, a study by HIV researcher David Ho did not come to this conclusion. An analysis by the pharmaceutical company Pfizer also found no resistance. The phenomenon of the rebound effect is currently being further investigated, the data situation is currently still insufficient.
Paxlovid and the rebound effect: these can be the consequences
According to CDC information, there is currently nothing to indicate that additional treatment is necessary after a corona rebound. Likewise, there is no information about serious illnesses after such a Covid relapse. Corresponding the US health authority continues to make the recommendationto treat high-risk patients with mild to moderate Covid-19 in the early stages of the disease with the drug Paxlovid.
That too Robert Koch Institute recommends Paxlovid in antiviral therapy for people at high risk of a severe course as first choice. The drug should be used in particular in unvaccinated or not fully vaccinated people with at least one risk factor to prevent severe courses. If a patient is at particularly high risk of severe disease, Paxlovid may also be prescribed to those who have been fully vaccinated.
Why the coronavirus drug Paxlovid is a “game changer” after all
For many, Paxlovid is a beacon of hope in the fight against the pandemic. Indeed, Yale University infectious disease specialist Scott Roberts considers Paxlovid a “game changer”: “It is truly our first effective oral antiviral pill against this virus. It shows a clear benefit and can actually prevent hospital admissions and deaths in at-risk patients.”
The physician and author Eric Topol takes a similar view. Last year he emphasized how important he considers Paxlovid in the fight against Corona. Because so far, the fight against the virus has relied on our immune system. But the Omikron variant partially bypassed the vaccination protection. Paxlovid, on the other hand, is not dependent on the immune response – and Omikron cannot escape the effects of the drug either. Federal Health Minister and epidemiologist Karl Lauterbach (SPD) confirmed this. “Paxlovid could become the strongest drug against the omicron variant,” he wrote on Twitter last December.
A comparison with other drugs also shows why the drug is considered such a beacon of hope: The US health authority FDA approved the antiviral drug molnupiravir in December last year, which, however, was only able to reduce the risk of hospitalization or death among high-risk patients by 30 percent . Depending on the study, Paxlovid is between 60 and 89 percent.
Coronavirus: Paxlovid as an alternative to vaccination?
Paxlovid has also been approved in the EU since the end of January. Germany has already ordered a million packs of the drug. However, as the WHO emphasizes, Paxlovid is not an alternative to vaccination. According to WHO expert Janet Diaz, vaccination is the most important way to prevent serious illness and reduce the risk of infection. Even mild infections could lead to long-term health problems.
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