Thread by @WesElyMD

1/🧵 Molnupiravir & Paxlovid are BOTH approved for EAU (emergency use) as pills for #Covid to reduce hospitalization and/or death if taken EARLY (w/in 5 days).

This ⬆️ our need for Rapid Tests!

Primary prevention is #Vaxx. 🤛

A few thoughts…

FDA - bit.ly/3ElTef1

2/ Which drug? When? Why?

Both drugs reduce likelihood of you being hospitalized if you take them early. The actual scientific publication of Pfizer’s #Paxlovid is not out yet, so I’m waiting to read peer-review data before firm stance.

But...

bit.ly/3Jc0Nsp

3/ Molnupiravir - 👇 @NEJM paper & conclusion.

You might think the story is clear. But it’s not.

1st half of study period yielded strong results but 2nd half did not…see 1 & 2.

Only 3% difference, so 1 improvement for every 33 pts treated.

bit.ly/3FEJ377

4/ See the KM curve & what we call a forest plot. All we want as investigators is truth. In this study, the truth is that #molnupiravir shows ~small & inconsistent changes.

Along w @EricTopol, I’m hoping for better from #paxlovid.

Read his review: ⭐️
bit.ly/3Fr69O7

5/ When? Why?

VIRUS vs. INFLAMMATION

These 2 pills are started w/in 5 days of getting #COVID to stop viral replication before our inflammatory cascade revs up & causes lots of organ 🫁 damage.

Neither prevents infection. We do that via #Mask #Vaccine #Boost #Distance

6/ Paxlovid - if preliminary reports hold up, these 💊 (plus HIV drug Ritonavir since they’re given together BID x5 days) ⬇️ hospitalization or death from 6% down to 1% compared to placebo if taken w/in 5 days of symptoms.

That means 1 improved “outcome” for every 25 treated.

7/fin
The supply chain will be the bottleneck for #molnupiravir & #paxlovid initially. The government, who bought them up, will distribute to retail pharmacies & institutions but there will be way more people who could receive them then will receive them.

#Pandemic #Hope

This is a great thread by @nickmmark on #Paxlovid...read and learn...

https://twitter.com/nickmmark/status/1456671588833652740?s=20

Thanks to @nickmmark for calibrating me that these drugs are technically “authorized” for emergency use, not “approved.” Functionally for us that doesn’t make a difference but it’s a reminder that we are still waiting for full @US_FDA “approval.”