Nirmatrelvir/ritonavi potential drug-drug interactions and their impact on patients with COVID-19:a retrospective study based on propensity score matching
Objective To determine the impact of potential drug-drug interactions(pDDI)of nirmatrelvir/ritonavir on the efficacy and safety of patients with COVID-19.Methods A retrospective analysis was conducted on 264 patients with COVID-19 who received nirmatrelvir/ritonavir in a hospital from Dec 1st,2022 to Feb 28st,2023.The patients were divided into a DDI group(n=163)and a non-DDI group(n=101)based on the presence of pDDI.After propensity score matching to balance the baseline characteristics of the two groups,the composite endpoint of disease progression(including admission to ICU,mechanical ventilation and mortality),length of hospital stay and incidence of adverse reactions were compared.Results The overall incidence of drug interactions was 61.74%,and the incidence of adverse reactions was 7.95%,with no serious adverse reactions.After the matching,no statistical differences were found in demographic characteristics,comorbidities,and laboratory indicators before and after the treatment between the DDI group(n=91)and the non-DDI group(n=101).The composite endpoint of disease progression(P=0.632),length of hospital stay(P=0.459),and incidence of drug adverse reactions(P=0.459)showed no significant difference between the two groups.Conclusion The pDDI of nirmatrelvir/ritonavir has no significant impact on patients with COVID-19.Due to the limitation in sample size,the conclusion needs further confirmation,high incidence of pDDI and adverse reactions should be avoided in clinical practice to ensure safe drug use.
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