Rebound COVID Is Just the Start of Paxlovid's Mysteries
The first data on Paxlovid, out last November, hinted that the COVID antiviral would cut the risk of hospitalization and death by 89 percent. But as the treatment spreads, so too does confusion over its effectiveness and side effects. An individual patient would never know if Paxlovid worked for them, because you could never say how sick you would have gotten if you hadn’t taken the pills. As for rebound, a Pfizer executive said during an earnings call this month that the company had taken a “preliminary look” at its trial data and concluded that viral loads bounced back up in about 2 percent of patients. The real number is—well, we have pretty much no idea what the real number is.
In an attempt to find some clarity, Wachter decided to poll his Twitter connections on whether they’d taken Paxlovid and rebounded. In short, Pfizer’s clinical-trial results may not be matching up with physicians’ and patients’ real-world experience. Discrepancies between the trial data and real-world experience might arise from the timing of the original research. Patients’ immunization status remains the most obvious difference between Pfizer’s published clinical trial and present-day reality. Providers are certainly anxious to know how many of their vaccinated patients experience Paxlovid rebound.
Pfizer has hinted at some sunny results in vaccinated people, but no data have been made publicly available. Today, that follow-up trial is still listed as in the “recruiting” phase on ClinicalTrials. To make the best decisions possible regarding prescribing Paxlovid, doctors and patients would need to understand how common rebounds are, whether the drug causes them, and whether people are infectious during the rebound period. Until those questions are answered, the providers I spoke with are all erring on the side of prescribing Paxlovid.
Read full article at The Atlantic