New findings from the NIHR-funded PANORAMIC trial and Canada’s CanTreatCOVID study show Paxlovid helps vaccinated higher-risk adults recover from COVID-19 faster, but does not reduce hospital admissions or deaths.
The combined analysis involved more than 4,200 participants worldwide, with over 98% vaccinated. Researchers studied adults aged over 50 and younger patients with conditions including asthma and diabetes.
Paxlovid was approved in 2021 after trials showed it reduced hospitalisation and death by 88% in unvaccinated high-risk adults. However, the latest findings, published in the New England Journal of Medicine, suggest benefits are more limited in vaccinated populations.
The results support recent NICE guidance narrowing routine NHS use to patients at highest risk, including transplant recipients and people with severe liver disease.
Led by the University of Oxford, PANORAMIC also pioneered remote trial methods such as online consent, couriered medication and self-collected samples, now influencing international respiratory studies.
Professor Christopher Butler, Nuffield Department of Primary Care Health Sciences, University of Oxford said:
“In today’s highly vaccinated populations exposed to the Omicron variant, the benefits of Paxlovid have fundamentally changed.
“While people feel better sooner, we found no reduction in the already low rate of hospitalisations or deaths. This provides essential high-quality evidence for optimal, cost-effective targeting of this treatment. Treatment is currently recommended for those at highest risk, and lowering this threshold is not supported by our findings.”
Professor Philip Evans, National Associate Director of Health and Care in the NIHR Research Delivery Network said:
“These results demonstrate the value of rapid, large-scale evidence generation through NIHR and university partnerships. The UK’s research infrastructure, built through the NIHR, enabled us to generate this evidence quickly in a primary care setting.
“PANORAMIC was accessible to all communities in all 4 countries of the UK, regardless of background, location, ethnicity, or socioeconomic status. In many ways, it paved the way for the shift from hospital to community, which we are increasingly seeing in health research.”
The PANORAMIC Platform Trial was supported by the Noclor Primary Care team and a number of GP sites in London. Further information on these results is available on the NIHR news site: Study provides important insight for the use of COVID-19 anti-viral, Paxlovid
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