Comparative effectiveness of sotrovimab and molnupiravir for preventing severe COVID-19 outcomes in patients on kidney replacement therapy : observational study using the OpenSAFELY-UKRR and SRR databases
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA..
Background: Due to limited inclusion of patients on kidney replacement therapy (KRT) in clinical trials, the effectiveness of coronavirus disease 2019 (COVID-19) therapies in this population remains unclear. We sought to address this by comparing the effectiveness of sotrovimab against molnupiravir, two commonly used treatments for non-hospitalised KRT patients with COVID-19 in the UK.
Methods: With the approval of National Health Service England, we used routine clinical data from 24 million patients in England within the OpenSAFELY-TPP platform linked to the UK Renal Registry (UKRR) to identify patients on KRT. A Cox proportional hazards model was used to estimate hazard ratios (HRs) of sotrovimab versus molnupiravir with regards to COVID-19-related hospitalisations or deaths in the subsequent 28 days. We also conducted a complementary analysis using data from the Scottish Renal Registry (SRR).
Results: Among the 2367 kidney patients treated with sotrovimab (n = 1852) or molnupiravir (n = 515) between 16 December 2021 and 1 August 2022 in England, 38 cases (1.6%) of COVID-19-related hospitalisations/deaths were observed. Sotrovimab was associated with substantially lower outcome risk than molnupiravir {adjusted HR 0.35 [95% confidence interval (CI) 0.17-0.71]; P = .004}, with results remaining robust in multiple sensitivity analyses. In the SRR cohort, sotrovimab showed a trend toward lower outcome risk than molnupiravir [HR 0.39 (95% CI 0.13-1.21); P = .106]. In both datasets, sotrovimab had no evidence of an association with other hospitalisation/death compared with molnupiravir (HRs ranged from 0.73 to 1.29; P > .05).
Conclusions: In routine care of non-hospitalised patients with COVID-19 on KRT, sotrovimab was associated with a lower risk of severe COVID-19 outcomes compared with molnupiravir during Omicron waves.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Clinical kidney journal - 16(2023), 11 vom: 11. Nov., Seite 2048-2058 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zheng, Bang [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 13.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/ckj/sfad184 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364078065 |
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| 100 | 1 | |a Zheng, Bang |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparative effectiveness of sotrovimab and molnupiravir for preventing severe COVID-19 outcomes in patients on kidney replacement therapy |b observational study using the OpenSAFELY-UKRR and SRR databases |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 13.03.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. | ||
| 520 | |a Background: Due to limited inclusion of patients on kidney replacement therapy (KRT) in clinical trials, the effectiveness of coronavirus disease 2019 (COVID-19) therapies in this population remains unclear. We sought to address this by comparing the effectiveness of sotrovimab against molnupiravir, two commonly used treatments for non-hospitalised KRT patients with COVID-19 in the UK | ||
| 520 | |a Methods: With the approval of National Health Service England, we used routine clinical data from 24 million patients in England within the OpenSAFELY-TPP platform linked to the UK Renal Registry (UKRR) to identify patients on KRT. A Cox proportional hazards model was used to estimate hazard ratios (HRs) of sotrovimab versus molnupiravir with regards to COVID-19-related hospitalisations or deaths in the subsequent 28 days. We also conducted a complementary analysis using data from the Scottish Renal Registry (SRR) | ||
| 520 | |a Results: Among the 2367 kidney patients treated with sotrovimab (n = 1852) or molnupiravir (n = 515) between 16 December 2021 and 1 August 2022 in England, 38 cases (1.6%) of COVID-19-related hospitalisations/deaths were observed. Sotrovimab was associated with substantially lower outcome risk than molnupiravir {adjusted HR 0.35 [95% confidence interval (CI) 0.17-0.71]; P = .004}, with results remaining robust in multiple sensitivity analyses. In the SRR cohort, sotrovimab showed a trend toward lower outcome risk than molnupiravir [HR 0.39 (95% CI 0.13-1.21); P = .106]. In both datasets, sotrovimab had no evidence of an association with other hospitalisation/death compared with molnupiravir (HRs ranged from 0.73 to 1.29; P > .05) | ||
| 520 | |a Conclusions: In routine care of non-hospitalised patients with COVID-19 on KRT, sotrovimab was associated with a lower risk of severe COVID-19 outcomes compared with molnupiravir during Omicron waves | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a cohort studies | |
| 650 | 4 | |a comparative effectiveness research | |
| 650 | 4 | |a renal replacement therapy | |
| 700 | 1 | |a Campbell, Jacqueline |e verfasserin |4 aut | |
| 700 | 1 | |a Carr, Edward J |e verfasserin |4 aut | |
| 700 | 1 | |a Tazare, John |e verfasserin |4 aut | |
| 700 | 1 | |a Nab, Linda |e verfasserin |4 aut | |
| 700 | 1 | |a Mahalingasivam, Viyaasan |e verfasserin |4 aut | |
| 700 | 1 | |a Mehrkar, Amir |e verfasserin |4 aut | |
| 700 | 1 | |a Santhakumaran, Shalini |e verfasserin |4 aut | |
| 700 | 1 | |a Steenkamp, Retha |e verfasserin |4 aut | |
| 700 | 1 | |a Loud, Fiona |e verfasserin |4 aut | |
| 700 | 1 | |a Lyon, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Scanlon, Miranda |e verfasserin |4 aut | |
| 700 | 1 | |a Hulme, William J |e verfasserin |4 aut | |
| 700 | 1 | |a Green, Amelia C A |e verfasserin |4 aut | |
| 700 | 1 | |a Curtis, Helen J |e verfasserin |4 aut | |
| 700 | 1 | |a Fisher, Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Parker, Edward |e verfasserin |4 aut | |
| 700 | 1 | |a Goldacre, Ben |e verfasserin |4 aut | |
| 700 | 1 | |a Douglas, Ian |e verfasserin |4 aut | |
| 700 | 1 | |a Evans, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a MacKenna, Brian |e verfasserin |4 aut | |
| 700 | 1 | |a Bell, Samira |e verfasserin |4 aut | |
| 700 | 1 | |a Tomlinson, Laurie A |e verfasserin |4 aut | |
| 700 | 1 | |a Nitsch, Dorothea |e verfasserin |4 aut | |
| 700 | 0 | |a OpenSAFELY Collaborative and LH&W NCS (or CONVALESCENCE) Collaborative |e verfasserin |4 aut | |
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