Antiviral therapy remains effective; alternative drugs addressing side effects are in the works
As the holiday and peak respiratory seasons collide, and COVID-19 cases continue a steady, weeks-long climb, doctors want high-risk people to remember: Should COVID catch them in the coming days, one call to the doctor could save Christmas - or more.
Paxlovid, an antiviral COVID therapy given under emergency use authorization (EUA) during the pandemic and now approved by prescription, prevents hospitalization and death between 60% and 80% of the time. The Food and Drug Administration (FDA) approved the drug in May for mild to moderate COVID in adults at high risk of developing severe illness.
State Hospitalizations Since Oct. 1 (as of Dec. 5)
(Source: Colorado Department of Public Health and Environment) |
"Over the past month, there's been a steady increase in both emergency room visits and hospitalizations for COVID," said Thomas Campbell, MD, a professor of infectious diseases at the University of Colorado School of Medicine. Yet uptake of Paxlovid remains relatively low, with experts attributing fears of a rebound effect and a catalogue of drug interactions longer than Santa's list.
Campbell advises people to at least make that call. Doctors can help weigh whether risks outweigh benefits, find alternatives to some drugs that have interactions and even offer alternative therapies in some cases, he said.
"It's important that to have its maximum benefit, Paxlovid is started as soon as possible after the onset of symptoms - not after diagnosis - and no more than five days after onset," Campbell said. Anyone with at least one high-risk factor should talk with their doctors, he said.
Nearly three-quarters of Americans fall in that group, with risk factors including diabetes, obesity, asthma, heart disease and being 50 or older so prevalent. High-risk youth between 12 and 18 years old can still receive Paxlovid under the EUA, and adults can receive a prescription directly from a pharmacist supplied with required health information.
As all emerging variants still reside within the omicron family, the newest booster shot, which wholly targets omicron, remains the best defense, Campbell said. And Paxlovid has maintained its effectiveness against the new variants, he said.
In the following Q&A, Campbell discusses pros and cons of Paxlovid and its alternatives as well as potential new options on the horizon, including one new drug targeting non-high-risk patients undergoing a clinical trial he is currently leading at the CU Anschutz Medical Campus.
