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Taskforce updates molnupiravir guidance following PANORAMIC trial results

02 December, 2022

The Taskforce has incorporated the preliminary results of the PANORAMIC trial into the body of evidence for oral antiviral molnupiravir (Lagevrio).

This large (25,783 participants) open-label randomised controlled trial was conducted in the UK, in patients who had multiple SARS-CoV-2 vaccine doses, during the Omicron wave, comparing molnupiravir to standard care.

The Taskforce Drug Treatments Panel, Care of Older People Panel, Expert Advisors in Aged Care, Guidelines Leadership Group and Steering Committee have considered this research and determined that there is now high certainty evidence that molnupiravir does not have an impact on the combined endpoint of hospitalisation and/or mortality in multiply-vaccinated adults with mild COVID-19 and one or more risk factors for disease progression.

The PANORAMIC trial results strengthen our existing position that nirmaltrelvir plus ritonavir (Paxlovid) and remdesivir (Veklury) are the preferred antivirals treatments for mild COVID, and that molnupiravir is not for routine use.

As a result, the Taskforce has made a conditional recommendation against:

Do not routinely use molnupiravir for the treatment of COVID-19.

Read the full recommendation for further information or the accompanying explainer: ‘Rationale for updated Taskforce recommendation on the use of molnupiravir.’

The decision tool for ‘Drug treatments for at risk adults with COVID-19 who do not require oxygen’ has been updated to reflect this change in guidance.