Elderly, immunocompromised or chronically ill people, and the unvaccinated should give priority to molnupiravir, the anti-Covid pill from the American Merck.
A World Health Organization (WHO) international expert panel of international experts on Wednesday recommended in the British Medical Journal (BMJ) that Merck's pill be reserved for "patients with non-severe Covid-19 who have the highest risk of hospitalization”.
In contrast, "young and healthy patients, including children, and pregnant and breastfeeding women" should not take the treatment, says the panel, which relied on new data from six randomized controlled trials. involving 4,796 patients.
Read alsoCovid-19: five minutes to understand the disappointment of Molnupiravir in France
The results of these trials suggest that molnupiravir reduces the risk of hospital admission (43 fewer admissions per 1,000 high-risk patients) and the time to resolution of symptoms (on average 3.4 days less ).
Less certain, they point to a weak effect on mortality (6 fewer deaths per 1,000 patients).
Since its US marketing authorization last December, molnupiravir has seen little success due to its limited effectiveness in relation to the difficulties of cost and availability of treatment, and concerns about potential side effects. .
For these reasons, the French health authorities refused Merck an early marketing authorization.
The trials could not say whether people with severe or critical illnesses could take the treatment.
The dosage of antiviral treatment is that it should be given soon after symptoms appear, and taken for five days to prevent the virus from replicating.
The Pfizer pill and Paxlovid should follow
The WHO expert group is also preparing recommendations for Pfizer's antiviral pill, Paxlovid.
This has been shown to be almost 90% effective in preventing hospitalizations and deaths from Covid-19, compared to 30% for molnupiravir.
France benefits from Paxlovid: it has purchased 500,000 doses for 2022 and received its first delivery at the end of January.
Experts also recommend a treatment combining Regeneron's monoclonal antibodies (casirivimab and imdevimab) only for people who are not infected with the Omicron variant.
Indeed, these antibodies proved ineffective against the variant that appeared in South Africa at the end of November.
In January, the panel recommended the use of Eli Lilly's baricitinib for patients with severe Covid, in combination with corticosteroids, and conditionally approved GlaxoSmithKline and Vir Biotechnology's antibody treatment for non-severe patients at greatest risk of hospitalization.
