Outcomes in COVID-19 molnupiravir studies
Outcomes in molnupiravir studies.
Potential risks of the mechanism of action include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity [Hadj Hassine , Swanstrom , Waters ] . See
[Fountain-Jones , Sanderson , twitter.com ] for analysis of variants potentially created by molnupiravir. There is substantial publication bias. Two trials (CTRI/2021/05/033864 and CTRI/2021/08/0354242) reported no significant efficacy, however the results have not been published. Multiple trials have not reported results and did not respond to requests
[Lawrence ] .
0
0.5
1
1.5+
All studies 16% 30
104,953
Improvement, Studies, Patients Relative Risk Mortality 23% 15
83,307
Ventilation 46% 5
7,016
ICU admission 19% 3
1,836
Hospitalization 2% 18
79,431
Progression 25% 5
33,432
Recovery 19% 7
25,629
Viral clearance 32% 9
7,043
RCTs 41% 12
30,687
RCT mortality 45% 4
26,955
Peer-reviewed 22% 21
76,802
Early 18% 26
81,226
Late 11% 4
23,727
Molnupiravir for COVID-19 c19 early.org/m Mar 2023Favors molnupiravir Favors control after exclusions
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT) 46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Wong (PSM) 52%
0.48 [0.40-0.59]
death
1,856 (n)
1,856 (n)
Yip (PSW) -12%
1.12 [0.68-1.82]
death/ICU
Flisiak 39%
0.61 [0.38-0.97]
death
20/203
63/387
AGILE CST-2
Khoo (DB RCT) 67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Kneidinger -15%
1.15 [0.56-2.37]
severe case
8/46
26/172
Najjar-Deb.. (PSM) 19%
0.81 [0.46-1.43]
death
22/2,661
27/2,661
Arbel 65+ 74%
0.26 [0.10-0.73]
death
4/845
137/12,724
Arbel 40-64 -1182%
12.82 [3.41-48.2]
death
4/224
7/6,075
Suzuki (PSM) -100%
2.00 [0.34-11.9]
death
2/230
3/690
Brown -101%
2.01 [0.43-9.38]
hosp.
8/442
2/222
PANORAMIC
Butler (RCT) 40%
0.60 [0.14-2.51]
death
3/12,529
5/12,525
Wong (PSM) 24%
0.76 [0.61-0.95]
death
Liu -162%
2.62 [0.11-60.6]
ICU
1/26
0/16
Sinha (RCT) 65%
0.35 [0.16-0.73]
hosp.
9/608
26/610
Zheng -100%
2.00 [1.23-3.23]
death/hosp.
61/2,689
34/3,331
OT1
Bajema (PSM) 18%
0.82 [0.52-1.29]
death
24/897
29.0/897
Inaba 58%
0.42 [0.02-10.1]
death
0/84
1/210
Zheng (PSW) -285%
3.85 [1.54-10.0]
death/hosp.
11/802
33/4,836
OT1
Evans 51%
0.49 [0.29-0.83]
death/hosp.
359 (n)
4,973 (n)
Goodwin -110%
2.10 [0.19-22.9]
death
1/80
2/336
Tau2 = 0.31, I2 = 80.9%, p = 0.17
Early treatment 18%
0.82 [0.61-1.09]
239/26,688
538.0/54,538
18% improvement 033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING2
Improvement, RR [CI] Treatment Control 035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING2
Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Wan 11%
0.89 [0.81-0.98]
death
704/6,153
2,541/17,283
Tau2 = 0.00, I2 = 0.0%, p = 0.0047
Late treatment 11%
0.89 [0.83-0.97]
715/6,369
2,542/17,358
11% improvement All studies 16%
0.84 [0.67-1.05]
954/33,057
3,080.0/71,896
16% improvement 30 molnupiravir COVID-19 studies c19 early.org/m Mar 2023Tau2 = 0.19, I2 = 80.3%, p = 0.12
Effect extraction pre-specified
1 OT: comparison with other treatment 2 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT) 46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Wong (PSM) 52%
0.48 [0.40-0.59]
death
1,856 (n)
1,856 (n)
Yip (PSW) -12%
1.12 [0.68-1.82]
death/ICU
Flisiak 39%
0.61 [0.38-0.97]
death
20/203
63/387
AGILE CST-2
Khoo (DB RCT) 67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Kneidinger -15%
1.15 [0.56-2.37]
severe case
8/46
26/172
Najjar-Deb.. (PSM) 19%
0.81 [0.46-1.43]
death
22/2,661
27/2,661
Arbel 65+ 74%
0.26 [0.10-0.73]
death
4/845
137/12,724
Arbel 40-64 -1182%
12.82 [3.41-48.2]
death
4/224
7/6,075
Suzuki (PSM) -100%
2.00 [0.34-11.9]
death
2/230
3/690
PANORAMIC
Butler (RCT) 40%
0.60 [0.14-2.51]
death
3/12,529
5/12,525
Wong (PSM) 24%
0.76 [0.61-0.95]
death
Liu -162%
2.62 [0.11-60.6]
ICU
1/26
0/16
Sinha (RCT) 65%
0.35 [0.16-0.73]
hosp.
9/608
26/610
Zheng -100%
2.00 [1.23-3.23]
death/hosp.
61/2,689
34/3,331
OT1
Bajema (PSM) 18%
0.82 [0.52-1.29]
death
24/897
29.0/897
Inaba 58%
0.42 [0.02-10.1]
death
0/84
1/210
Evans 51%
0.49 [0.29-0.83]
death/hosp.
359 (n)
4,973 (n)
Goodwin -110%
2.10 [0.19-22.9]
death
1/80
2/336
Tau2 = 0.25, I2 = 77.9%, p = 0.026
Early treatment 27%
0.73 [0.56-0.96]
220/25,444
503.0/49,480
27% improvement 033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING2
Improvement, RR [CI] Treatment Control 035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING2
Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Wan 11%
0.89 [0.81-0.98]
death
704/6,153
2,541/17,283
Tau2 = 0.00, I2 = 0.0%, p = 0.0047
Late treatment 11%
0.89 [0.83-0.97]
715/6,369
2,542/17,358
11% improvement All studies 23%
0.77 [0.62-0.96]
935/31,813
3,045.0/66,838
23% improvement 28 molnupiravir COVID-19 studies after exclusions c19 early.org/m Mar 2023Tau2 = 0.16, I2 = 78.5%, p = 0.018
Effect extraction pre-specified
1 OT: comparison with other treatment 2 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
0/140
1/62
Improvement, RR [CI] Treatment Control Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
1/709
9/699
Wong (PSM) 52%
0.48 [0.40-0.59]
1,856 (n)
1,856 (n)
Flisiak 39%
0.61 [0.38-0.97]
20/203
63/387
Najjar-Deb.. (PSM) 19%
0.81 [0.46-1.43]
22/2,661
27/2,661
Arbel 65+ 74%
0.26 [0.10-0.73]
4/845
137/12,724
Arbel 40-64 -1182%
12.82 [3.41-48.2]
4/224
7/6,075
Suzuki (PSM) -100%
2.00 [0.34-11.9]
2/230
3/690
PANORAMIC
Butler (RCT) 40%
0.60 [0.14-2.51]
3/12,529
5/12,525
Wong (PSM) 24%
0.76 [0.61-0.95]
Bajema (PSM) 18%
0.82 [0.52-1.29]
24/897
29.0/897
Inaba 58%
0.42 [0.02-10.1]
0/84
1/210
Goodwin -110%
2.10 [0.19-22.9]
1/80
2/336
Tau2 = 0.20, I2 = 72.9%, p = 0.094
Early treatment 27%
0.73 [0.51-1.06]
81/20,458
284.0/39,122
27% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
11/216
1/75
Improvement, RR [CI] Treatment Control Wan 11%
0.89 [0.81-0.98]
704/6,153
2,541/17,283
Tau2 = 0.52, I2 = 49.4%, p = 0.71
Late treatment -28%
1.28 [0.37-4.38]
715/6,369
2,542/17,358
28% increased risk All studies 23%
0.77 [0.57-1.03]
796/26,827
2,826.0/56,480
23% improvement 15 molnupiravir COVID-19 mortality results c19 early.org/m Mar 2023Tau2 = 0.14, I2 = 79.5%, p = 0.08
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Wong (PSM) 58%
0.42 [0.17-1.01]
1,856 (n)
1,856 (n)
Improvement, RR [CI] Treatment Control Flisiak 5%
0.95 [0.39-2.32]
7/203
14/387
Suzuki (PSM) 57%
0.43 [0.02-10.5]
0/230
1/690
Wong (PSM) 60%
0.40 [0.19-0.84]
Bajema (PSM) 17%
0.83 [0.17-4.12]
3/897
3.6/897
Tau2 = 0.00, I2 = 0.0%, p = 0.0083
Early treatment 46%
0.54 [0.34-0.85]
10/3,186
18.6/3,830
46% improvement All studies 46%
0.54 [0.34-0.85]
10/3,186
18.6/3,830
46% improvement 5 molnupiravir COVID-19 mechanical ventilation results c19 early.org/m Mar 2023Tau2 = 0.00, I2 = 0.0%, p = 0.0083
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Wong (PSM) 26%
0.74 [0.45-1.21]
Improvement, RR [CI] Treatment Control Liu -162%
2.62 [0.11-60.6]
1/26
0/16
Bajema (PSM) 1%
0.99 [0.41-2.37]
10/897
10.1/897
Tau2 = 0.00, I2 = 0.0%, p = 0.35
Early treatment 19%
0.81 [0.53-1.25]
11/923
10.1/913
19% improvement All studies 19%
0.81 [0.53-1.25]
11/923
10.1/913
19% improvement 3 molnupiravir COVID-19 ICU results c19 early.org/m Mar 2023Tau2 = 0.00, I2 = 0.0%, p = 0.35
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) -33%
1.33 [0.14-12.5]
hosp.
3/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Tippabhotla (RCT) 46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Wong (PSM) 6%
0.94 [0.89-1.00]
hosp. time
1,856 (n)
1,856 (n)
Yip (PSW) -17%
1.17 [0.99-1.39]
hosp.
Flisiak -1%
1.01 [0.71-1.43]
hosp. time
203 (n)
387 (n)
AGILE CST-2
Khoo (DB RCT) 89%
0.11 [0.01-2.03]
hosp.
0/90
4/90
Arbel 65+ 45%
0.55 [0.34-0.88]
hosp.
18/845
513/12,724
Arbel 40-64 -80%
1.80 [0.86-3.77]
hosp.
8/224
97/6,075
Brown -101%
2.01 [0.43-9.38]
hosp.
8/442
2/222
PANORAMIC
Butler (RCT) -7%
1.07 [0.81-1.41]
hosp.
103/12,529
96/12,525
Wong (PSM) 2%
0.98 [0.89-1.06]
hosp.
Liu 18%
0.82 [0.63-1.06]
hosp. time
26 (n)
16 (n)
Sinha (RCT) 65%
0.35 [0.16-0.73]
hosp.
9/608
26/610
Bajema (PSM) -30%
1.30 [1.01-1.68]
hosp.
162/897
124.3/897
Inaba -127%
2.27 [0.60-7.25]
hosp.
5/84
8/210
Goodwin 58%
0.42 [0.05-3.23]
hosp.
1/80
10/336
Tau2 = 0.02, I2 = 69.9%, p = 0.6
Early treatment 3%
0.97 [0.86-1.09]
331/19,005
917.3/36,990
3% improvement Wan 1%
0.99 [0.93-1.05]
hosp.
2,298/6,153
2,541/17,283
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.7
Late treatment 1%
0.99 [0.93-1.05]
2,298/6,153
2,541/17,283
1% improvement All studies 2%
0.98 [0.90-1.08]
2,629/25,158
3,458.3/54,273
2% improvement 18 molnupiravir COVID-19 hospitalization results c19 early.org/m Mar 2023Tau2 = 0.01, I2 = 68.1%, p = 0.73
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT) 46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Wong (PSM) 52%
0.48 [0.40-0.59]
death
1,856 (n)
1,856 (n)
Yip (PSW) -12%
1.12 [0.68-1.82]
death/ICU
Flisiak 39%
0.61 [0.38-0.97]
death
20/203
63/387
AGILE CST-2
Khoo (DB RCT) 67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Kneidinger -15%
1.15 [0.56-2.37]
severe case
8/46
26/172
Najjar-Deb.. (PSM) 19%
0.81 [0.46-1.43]
death
22/2,661
27/2,661
Arbel 65+ 74%
0.26 [0.10-0.73]
death
4/845
137/12,724
Arbel 40-64 -1182%
12.82 [3.41-48.2]
death
4/224
7/6,075
Suzuki (PSM) -100%
2.00 [0.34-11.9]
death
2/230
3/690
Brown -101%
2.01 [0.43-9.38]
hosp.
8/442
2/222
PANORAMIC
Butler (RCT) 40%
0.60 [0.14-2.51]
death
3/12,529
5/12,525
Wong (PSM) 24%
0.76 [0.61-0.95]
death
Liu -162%
2.62 [0.11-60.6]
ICU
1/26
0/16
Sinha (RCT) 65%
0.35 [0.16-0.73]
hosp.
9/608
26/610
Zheng -100%
2.00 [1.23-3.23]
death/hosp.
61/2,689
34/3,331
OT1
Bajema (PSM) 18%
0.82 [0.52-1.29]
death
24/897
29.0/897
Inaba 58%
0.42 [0.02-10.1]
death
0/84
1/210
Zheng (PSW) -285%
3.85 [1.54-10.0]
death/hosp.
11/802
33/4,836
OT1
Evans 51%
0.49 [0.29-0.83]
death/hosp.
359 (n)
4,973 (n)
Goodwin -110%
2.10 [0.19-22.9]
death
1/80
2/336
Tau2 = 0.32, I2 = 80.4%, p = 0.26
Early treatment 16%
0.84 [0.62-1.14]
193/26,501
442.0/54,352
16% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Improvement, RR [CI] Treatment Control Wan 11%
0.89 [0.81-0.98]
death
704/6,153
2,541/17,283
Tau2 = 0.52, I2 = 49.4%, p = 0.71
Late treatment -28%
1.28 [0.37-4.38]
715/6,369
2,542/17,358
28% increased risk All studies 15%
0.85 [0.67-1.08]
908/32,870
2,984.0/71,710
15% improvement 26 molnupiravir COVID-19 serious outcomes c19 early.org/m Mar 2023Tau2 = 0.19, I2 = 80.4%, p = 0.19
Effect extraction pre-specified (most serious outcome) 1 OT: comparison with other treatment Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Hetero (RCT) 33%
0.67 [0.54-0.82]
recov. time
371 (n)
370 (n)
Improvement, RR [CI] Treatment Control Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
AGILE CST-2
Khoo (DB RCT) -12%
1.12 [0.71-1.79]
no recov.
27/90
24/90
PANORAMIC
Butler (RCT) 22%
0.78 [0.75-0.81]
no recov.
3,856/12,403
4,838/12,140
Tau2 = 0.01, I2 = 50.4%, p = 0.0059
Early treatment 21%
0.79 [0.66-0.93]
3,891/12,876
4,865/12,606
21% improvement 033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI] Treatment Control 035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT) 1%
0.99 [0.68-1.45]
no recov.
72 (n)
75 (n)
Tau2 = 0.00, I2 = 0.0%, p = 0.97
Late treatment 1%
0.99 [0.74-1.34]
0/72
0/75
1% improvement All studies 19%
0.81 [0.71-0.92]
3,891/12,948
4,865/12,681
19% improvement 7 molnupiravir COVID-19 recovery results c19 early.org/m Mar 2023Tau2 = 0.01, I2 = 30.0%, p = 0.0017
1 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 49%
0.51 [0.22-1.18]
viral+
10/118
9/54
Improvement, RR [CI] Treatment Control Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Tippabhotla (RCT) 59%
0.41 [0.29-0.57]
viral+
42/610
103/610
Wong (PSM) 28%
0.72 [0.61-0.87]
viral+
1,856 (n)
1,856 (n)
AGILE CST-2
Khoo (DB RCT) 23%
0.77 [0.58-1.09]
viral+
90 (n)
90 (n)
PANORAMIC
Butler (RCT) -95%
1.95 [1.15-3.31]
viral load
21 (n)
11 (n)
Liu 21%
0.79 [0.59-1.05]
viral time
26 (n)
16 (n)
Sinha (RCT) 48%
0.52 [0.42-0.63]
viral load
608 (n)
610 (n)
Tau2 = 0.10, I2 = 82.8%, p = 0.0012
Early treatment 35%
0.65 [0.51-0.84]
90/3,504
205/3,427
35% improvement Arribas (DB RCT) 12%
0.88 [0.62-1.25]
viral+
26/52
34/60
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.49
Late treatment 12%
0.88 [0.62-1.25]
26/52
34/60
12% improvement All studies 32%
0.68 [0.53-0.86]
116/3,556
239/3,487
32% improvement 9 molnupiravir COVID-19 viral clearance results c19 early.org/m Mar 2023Tau2 = 0.10, I2 = 81.8%, p = 0.0013
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT) 46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
AGILE CST-2
Khoo (DB RCT) 67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
PANORAMIC
Butler (RCT) 40%
0.60 [0.14-2.51]
death
3/12,529
5/12,525
Sinha (RCT) 65%
0.35 [0.16-0.73]
hosp.
9/608
26/610
Tau2 = 0.04, I2 = 15.0%, p < 0.0001
Early treatment 55%
0.45 [0.32-0.62]
73/15,244
174/15,152
55% improvement 033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI] Treatment Control 035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Tau2 = 0.00, I2 = 0.0%, p = 0.77
Late treatment -8%
1.08 [0.67-1.73]
11/216
1/75
8% increased risk All studies 41%
0.59 [0.40-0.86]
84/15,460
175/15,227
41% improvement 12 molnupiravir COVID-19 Randomized Controlled Trials c19 early.org/m Mar 2023Tau2 = 0.18, I2 = 49.5%, p = 0.0069
Effect extraction pre-specified
1 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
0/140
1/62
Improvement, RR [CI] Treatment Control Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
1/709
9/699
PANORAMIC
Butler (RCT) 40%
0.60 [0.14-2.51]
3/12,529
5/12,525
Tau2 = 0.00, I2 = 0.0%, p = 0.048
Early treatment 67%
0.33 [0.11-0.99]
4/13,378
15/13,286
67% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
11/216
1/75
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment -282%
3.82 [0.50-29.1]
11/216
1/75
282% increased risk All studies 45%
0.55 [0.13-2.38]
15/13,594
16/13,361
45% improvement 4 molnupiravir COVID-19 RCT mortality results c19 early.org/m Mar 2023Tau2 = 1.13, I2 = 51.1%, p = 0.43
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Improvement, RR [CI] Treatment Control Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tippabhotla (RCT) 46%
0.54 [0.22-1.34]
hosp.
7/610
13/610
Wong (PSM) 52%
0.48 [0.40-0.59]
death
1,856 (n)
1,856 (n)
Yip (PSW) -12%
1.12 [0.68-1.82]
death/ICU
Flisiak 39%
0.61 [0.38-0.97]
death
20/203
63/387
AGILE CST-2
Khoo (DB RCT) 67%
0.33 [0.01-8.08]
oxygen
0/90
1/90
Kneidinger -15%
1.15 [0.56-2.37]
severe case
8/46
26/172
Najjar-Deb.. (PSM) 19%
0.81 [0.46-1.43]
death
22/2,661
27/2,661
Suzuki (PSM) -100%
2.00 [0.34-11.9]
death
2/230
3/690
Brown -101%
2.01 [0.43-9.38]
hosp.
8/442
2/222
PANORAMIC
Butler (RCT) 40%
0.60 [0.14-2.51]
death
3/12,529
5/12,525
Wong (PSM) 24%
0.76 [0.61-0.95]
death
Liu -162%
2.62 [0.11-60.6]
ICU
1/26
0/16
Sinha (RCT) 65%
0.35 [0.16-0.73]
hosp.
9/608
26/610
Zheng -100%
2.00 [1.23-3.23]
death/hosp.
61/2,689
34/3,331
OT1
Evans 51%
0.49 [0.29-0.83]
death/hosp.
359 (n)
4,973 (n)
Goodwin -110%
2.10 [0.19-22.9]
death
1/80
2/336
Tau2 = 0.20, I2 = 74.2%, p = 0.045
Early treatment 25%
0.75 [0.57-0.99]
158/23,521
237/29,554
25% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Improvement, RR [CI] Treatment Control Wan 11%
0.89 [0.81-0.98]
death
704/6,153
2,541/17,283
Tau2 = 0.52, I2 = 49.4%, p = 0.71
Late treatment -28%
1.28 [0.37-4.38]
715/6,369
2,542/17,358
28% increased risk All studies 22%
0.78 [0.62-0.98]
873/29,890
2,779/46,912
22% improvement 21 molnupiravir COVID-19 peer reviewed studies c19 early.org/m Mar 2023Tau2 = 0.12, I2 = 76.1%, p = 0.03
Effect extraction pre-specified (most serious outcome) 1 OT: comparison with other treatment Favors molnupiravir
Favors control
