SARS-CoV-2 Infection
Conditions
Keywords
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19), Paxlovid, Nirmatrelvir
Brief summary
The purpose of this post marketing observational study is to learn about the safety and effects of the commercial medicine (called PAXLOVID) for the treatment of COVID-19. This study is intended to be registered with the participants who: * Have taken PAXLOVID PACK and have no history of using this medicine. * Are 12 years and older All participants will receive PAXLOVID, a standard treatment for COVID-19. Participants will take PAXLOVID 2 times a day by mouth or as prescribed. We will examine the experiences of people taking PAXLOVID. This will help us determine if PAXLOVID is safe and effective. Participants will be followed up for 28 days after taking PAXLOVID. During this time, participants will be closely watched for the safety and effects of PAXLOVID.
Detailed description
This is a multicenter cohort study to be conducted in individuals with SARS-CoV-2 infection who are treated with this product, and the investigator will enter the information required in this study in the case report forms (CRFs) based on the information obtained through medical records.
Interventions
The usual dosage in adults and pediatric patients (≥12 years of age weighing ≥40 kg) is 300 mg of Nirmatrelvir and 100 mg of ritonavir all taken together orally twice daily for 5 days.
Sponsors
Study design
Eligibility
Inclusion criteria
* Subjects who are administered PAXLOVID PACK and have no history of using this drug.
Exclusion criteria
* There are no
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Adverse Drug Reactions | From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 45 days. | Adverse drug reaction (ADR) was a treatment-related adverse event and any untoward medical occurrence attributed to Paxlovid PACK in a participant who received Paxlovid PACK. Serious adverse drug reaction (SADR) was a treatment-related adverse event resulting in any of the following outcomes or deemed significant for any other reason: death; life-threatening; initial or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect. Relatedness to Paxlovid PACK was assessed by the physician. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Worsening Severity (Efficacy Analysis Set #1) | From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 45 days. | Whether the severity of infection caused by SARS-CoV-2 had worsened was evaluated. However, when the severity was severe at the start of Paxlovid PACK and did not worsen during the observation period, it was considered as severe at the start of treatment. |
| Percentage of Participants With Worsening Severity (Efficacy Analysis Set #2) | From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 35 days. | Whether the severity of infection caused by SARS-CoV-2 had worsened was evaluated. However, when the severity was severe at the start of Paxlovid PACK and did not worsen during the observation period, it was considered as severe at the start of treatment. |
| Percentage of Participants With Worsening Severity (Efficacy Analysis Set #3) | From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 35 days. | Whether the severity of infection caused by SARS-CoV-2 had worsened was evaluated. However, when the severity was severe at the start of Paxlovid PACK and did not worsen during the observation period, it was considered as severe at the start of treatment. |
| Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3) | 3, 5, 7, 14, 21 and 28 days after the start of administration with Paxlovid PACK. | The percent probability is the percent of the participants who had COVID-19 related hospitalization or death from any cause. |
| Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3) | 3, 5, 7, 14, 21 and 28 days after the start of administration with Paxlovid PACK. | The percent probability is the percent of the participants who had COVID-19 related hospitalization or death from any cause. Sensitivity analysis was conducted by changing the event definition of hospitalization for treatment of infection caused by SARS-CoV-2 as follows: there were concomitant medications for infection caused by SARS-CoV-2 or concomitant non-drug therapies due to infection caused by SARS-CoV-2 on or after the date of administration. |
Countries
Japan
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Paxlovid PACK (Nirmatrelvir/Ritonavir) Participants who received Paxlovid PACK as indicated in the approved local product document for the first time were observed from the start date of treatment with Paxlovid PACK to 28 days after the end of treatment (the day following the end of treatment was defined as Day 1). The dosage can be adjusted as per physician's discretion. | 2,829 |
| Total | 2,829 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | CRF not collected | 1 |
| Overall Study | No informed consent for publication of study results | 397 |
Baseline characteristics
| Characteristic | Paxlovid PACK (Nirmatrelvir/Ritonavir) | — |
|---|---|---|
| Age, Customized ≥15 and <65 years | 1404 Participants | — |
| Age, Customized <15 years | 2 Participants | — |
| Age, Customized ≥65 years | 1423 Participants | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Sex: Female, Male Female | 1324 Participants | — |
| Sex: Female, Male Male | 1505 Participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 16 / 2,829 |
| other Total, other adverse events | 474 / 2,829 |
| serious Total, serious adverse events | 51 / 2,829 |
Outcome results
Incidence of Adverse Drug Reactions
Adverse drug reaction (ADR) was a treatment-related adverse event and any untoward medical occurrence attributed to Paxlovid PACK in a participant who received Paxlovid PACK. Serious adverse drug reaction (SADR) was a treatment-related adverse event resulting in any of the following outcomes or deemed significant for any other reason: death; life-threatening; initial or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect. Relatedness to Paxlovid PACK was assessed by the physician.
Time frame: From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 45 days.
Population: The safety analysis set (2829 participants) comprised of participants who satisfied the inclusion criteria. Participants with no informed consent for publication of study results, no information on administration, and no information on adverse events - no re-visits were excluded.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Incidence of Adverse Drug Reactions | ADR | 423 Participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Incidence of Adverse Drug Reactions | SADR | 6 Participants |
Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3)
The percent probability is the percent of the participants who had COVID-19 related hospitalization or death from any cause.
Time frame: 3, 5, 7, 14, 21 and 28 days after the start of administration with Paxlovid PACK.
Population: For the efficacy analysis set #3 (1905 participants), participants with no risk factors of progressing to severe illness (60 participants) were excluded from the efficacy analysis set #2.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3) | 3 days from the start of administration of this drug | 3.99 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3) | 5 days from the start of administration of this drug | 4.41 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3) | 7 days from the start of administration of this drug | 4.47 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3) | 14 days from the start of administration of this drug | 4.80 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3) | 21 days from the start of administration of this drug | 4.86 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Efficacy Analysis Set #3) | 28 days from the start of administration of this drug | 4.92 Percent probability |
Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3)
The percent probability is the percent of the participants who had COVID-19 related hospitalization or death from any cause. Sensitivity analysis was conducted by changing the event definition of hospitalization for treatment of infection caused by SARS-CoV-2 as follows: there were concomitant medications for infection caused by SARS-CoV-2 or concomitant non-drug therapies due to infection caused by SARS-CoV-2 on or after the date of administration.
Time frame: 3, 5, 7, 14, 21 and 28 days after the start of administration with Paxlovid PACK.
Population: For the efficacy analysis set #3 (1905 participants), participants with no risk factors of progressing to severe illness (60 participants) were excluded from the efficacy analysis set #2.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3) | 3 days from the start of administration of this drug | 1.42 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3) | 5 days from the start of administration of this drug | 1.58 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3) | 7 days from the start of administration of this drug | 1.58 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3) | 14 days from the start of administration of this drug | 1.75 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3) | 21 days from the start of administration of this drug | 1.75 Percent probability |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Cumulative Incidence Rate of COVID-19 Related Hospitalization or Death From Any Cause Through Day 28 (Sensitivity Analysis) (Efficacy Analysis Set #3) | 28 days from the start of administration of this drug | 1.80 Percent probability |
Percentage of Participants With Worsening Severity (Efficacy Analysis Set #1)
Whether the severity of infection caused by SARS-CoV-2 had worsened was evaluated. However, when the severity was severe at the start of Paxlovid PACK and did not worsen during the observation period, it was considered as severe at the start of treatment.
Time frame: From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 45 days.
Population: For the efficacy analysis set #1 (2828 participants), participant with disease not subject to the study (1 participant) was excluded from the safety analysis set.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #1) | Worsened | 2.19 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #1) | Not worsened | 94.77 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #1) | Severe at the start of treatment | 0 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #1) | Unknown (worsening unknown) | 3.04 Percentage of participants |
Percentage of Participants With Worsening Severity (Efficacy Analysis Set #2)
Whether the severity of infection caused by SARS-CoV-2 had worsened was evaluated. However, when the severity was severe at the start of Paxlovid PACK and did not worsen during the observation period, it was considered as severe at the start of treatment.
Time frame: From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 35 days.
Population: For the efficacy analysis set #2 (1965 participants), participants other than outpatient at the start of treatment (863 participants) were excluded from the efficacy analysis set #1.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #2) | Worsened | 1.63 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #2) | Not worsened | 94.66 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #2) | Severe at the start of treatment | 0 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #2) | Unknown (worsening unknown) | 3.72 Percentage of participants |
Percentage of Participants With Worsening Severity (Efficacy Analysis Set #3)
Whether the severity of infection caused by SARS-CoV-2 had worsened was evaluated. However, when the severity was severe at the start of Paxlovid PACK and did not worsen during the observation period, it was considered as severe at the start of treatment.
Time frame: From the start date of treatment with Paxlovid PACK to 28 days after the end of treatment, up to approximately 35 days.
Population: For the efficacy analysis set #3 (1905 participants), participants with no risk factors of progressing to severe illness (60 participants) were excluded from the efficacy analysis set #2.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #3) | Worsened | 1.68 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #3) | Not worsened | 94.59 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #3) | Severe at the start of treatment | 0 Percentage of participants |
| Paxlovid PACK (Nirmatrelvir/Ritonavir) | Percentage of Participants With Worsening Severity (Efficacy Analysis Set #3) | Unknown (worsening unknown) | 3.73 Percentage of participants |