Paxlovid didn’t provide any benefit in a placebo-controlled randomized trial in lower risk (mean age 42 years) outpatients with mild-to-moderate Covid
@erictopol and wow o wow are they pushing commercials of this product on paramount +
@sergiodomeyko @erictopol it's effective for high-risk patients for a severe systemic infection
@erictopol Well fuck. I thought it at least lowered the odds of Long COVID. Sigh
@DaywalkingRedhead This study didn't look at long COVID, though. It only looked at length of acute recovery and deaths or hospitalizations within 28 days.
@eladnarra Ah… that’s different than “no benefit”. My bad.
@DaywalkingRedhead Yeah - but no worries, it wasn't your bad!
It's not clear if they really studied long covid at all in this study. at least from the screenshot.
@dlakelan @DaywalkingRedhead @erictopol I think it’s pretty clear they didn’t.
@erictopol "It didn't speed up recovery of acute illness" isn't the same as "didn't provide any benefit." If I'm understanding this correctly, it didn't look at long COVID at all, which would be my main concern for younger, relatively healthy patients.
So anecdotally, the antivirals helped me immensely - but by the criteria of the study the treatment was a failure because it didn't completely negate the disease!
I'll take reduced symptoms thanks.
@LyallMorrison @eladnarra @erictopol In my case: Different continent, same approach, same outcome (except for a relapse two days later).
I will also by any means choose reduced symptoms if I get infected again.
@erictopol for that reason EPIC-SR trial was ended early
@erictopol this seems important for those who required hospitalization: “Among the 15 participants who were hospitalized, the mean number of days in the hospital per 100 participants was 5 in the nirmatrelvir–ritonavir group and 18 in the placebo group. The longest hospital stay was 9 days in the nirmatrelvir–ritonavir group and 32 days in the placebo group.”
@erictopol
Interesting. But I've never heard of it being given to anyone under 60.
@joehill @erictopol it was given to my 41 year old son-in-law. He is super high risk though.
@joehill @erictopol
I caught Covid (my only infection of the pandemic) in October 2023. I am 55 with no other risks and I got Plaxlovid from my doctor.
@erictopol
Oh, good, I get to stop prescribing Paxlovid to all those rich yuppies with an overblown sense of self-entitlement.
"But you GOTTA give me a prescription, doctor! I have a big presentation next week!"
Well, excuuuse me for permitting illness to exist in your world!
Also, this rebound side effect that's supposedly rare happened to two of my patients. Got COVID again 10 days after taking Paxlovid. Two unrelated cases. One was a mom of a 3-month old.
#Paxlovid
@familydoctor @erictopol To anonymously call patients “self-entitled yuppies” is questionable at best.
Also, COVID relapses are not “supposedly rare”, but I guess more is missed by not looking than by not knowing…
This study found 20%:
https://www.acpjournals.org/doi/10.7326/M23-1756
Yale finds similar numbers (15%), also 9% relapse rate for people without Paxlovid:
https://www.yalemedicine.org/news/what-is-paxlovid-rebound-covid-rebound
Thanks for your response.
You seem to assume that, when I say "self-entitled yuppies", I am referring to patients in general. In fact, I'm talking about those who are self-entitled yuppies. There are quite a number in my practice.
You seem to assume that I think the rebound effect is rare. In fact, I used the word "supposedly" to connote that patients dismiss the possible side effects of Paxlovid as rare in asking me to prescribe it unnecessarily.
@familydoctor 1. You‘re wrong, I did not assume that.
2. Wrong again. I assumed you don’t have a clue and badly need some schooling. I still do.
Your behavior was immature and unprofessional.
I called you out on it.
Case closed, colleagoid.
@erictopol not the same test cohort, but going to pass along some family member anecdata:
73 yo healthy woman, awakes with severe symptoms and tests antigen test positive. Starts pax three hours later. She was in the JnJ vax study, so she notified them and they start pcr testing her daily. Feels significantly better the next day. Tests pcr negative four days post symptom onset. Continues antigen testing for the next week, no rebound.