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The randomized trial that led to approval of nirmatrelvir/ritonavir (Paxlovid) for outpatients with COVID-19 (EPIC-HR) was conducted mainly in 2021 and showed that Paxlovid lowered risk for hospitalization or death in high-risk unvaccinated patients (NEJM JW Gen Med Apr 15 2022 and N Engl J Med 2022; 386:1397). However, a subsequent trial, conducted in late 2021 and early 2022 in “standard-risk” patients (EPIC-SR), did not show statistically significant benefits.
To examine Paxlovid's effectiveness more recently, investigators in British Columbia conducted this postmarketing study of high-risk outpatients who received diagnoses of COVID-19 between February 2022 and February 2023. About 3500 patients who received Paxlovid were compared with t…