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J Am Coll Clin Pharm . Nirmatrelvir-ritonavir treatment of COVID-19 in a high-risk patient population: A retrospective observational study

tetano

Editor, Senior Moderator
J Am Coll Clin Pharm


. 2023 Jan;6(1):29-33.
doi: 10.1002/jac5.1729. Epub 2022 Nov 16.
Nirmatrelvir-ritonavir treatment of COVID-19 in a high-risk patient population: A retrospective observational study


Anna M Kane[SUP] 1 [/SUP], Erica M Keenan[SUP] 1 [/SUP], Kasheng Lee[SUP] 1 [/SUP], Katherine J Hartkopf[SUP] 1 [/SUP], Trisha A Ludwig[SUP] 1 [/SUP], Philip J Trapskin[SUP] 1 [/SUP], Joshua P Vanderloo[SUP] 1 [/SUP], Lucas T Schulz[SUP] 1 [/SUP]



Affiliations

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a highly contagious, airborne viral infection that can infect anyone. Those with certain underlying conditions may be at higher risk for infection to develop into a severe disease requiring hospitalization. This report summarizes use of nirmatrelvir-ritonavir for the treatment of COVID-19 in high-risk patients at a single academic medical center through a pharmacist delegation protocol and demonstrates real-world efficacy and safety of treatment.
Methods: This retrospective, single-center, observational study analyzed all patients who received nirmatrelvir-ritonavir ordered by a clinical pharmacist for treatment of COVID-19 infection. The primary outcomes were safety and efficacy of nirmatrelvir-ritonavir. Safety was evaluated by analyzing drug interaction management and adverse events. Efficacy was evaluated through hospitalization and death within 28 days of nirmatrelvir-ritonavir use.
Results: Sixty patients were eligible for inclusion. No patients were hospitalized or died within 28 days after initiation of nirmatrelvir-ritonavir. Pharmacists identified 101 drug interactions with 60% considered clinically significant, requiring modification of home medications. Adverse outcomes associated with the use of nirmatrelvir-ritonavir were reported in 13 patients (21.7%).
Conclusions: A comprehensive program to mitigate drug interactions and prescribe nirmatrelvir-ritonavir ensured timely access to COVID-19 therapy, which may be associated with the prevention of hospitalization and death.

Keywords: COVID‐19; SARS‐CoV‐2; nirmatrelvir; pharmacist; ritonavir.
 
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