Outcomes in COVID-19 molnupiravir studies
Outcomes in molnupiravir studies. There is substantial positive publication bias. Two trials
(CTRI/2021/05/033864, and CTRI/2021/08/0354242) have reported
no significant efficacy, however the results have not been published
yet. Concerns have been raised that the mutagenic mechanism of
action may create dangerous variants or cause cancer.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tau2 = 0.24, I2 = 53.7%, p = 0.013
Early treatment 55%
0.45 [0.24-0.85]
54/1,407
129/1,317
55% improvement 033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI] Treatment Control 035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Tau2 = 0.00, I2 = 0.0%, p = 0.77
Late treatment -8%
1.08 [0.67-1.73]
11/216
1/75
-8% improvement All studies 34%
0.66 [0.38-1.13]
65/1,623
130/1,392
34% improvement 8 molnupiravir COVID-19 studies c19mp.com Jan 21, 2022
Tau2 = 0.32, I2 = 65.6%, p = 0.13
Effect extraction pre-specified
1 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
0/140
1/62
Improvement, RR [CI] Treatment Control Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
1/709
9/699
Tau2 = 0.00, I2 = 0.0%, p = 0.024
Early treatment 86%
0.14 [0.02-0.78]
1/849
10/761
86% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
11/216
1/75
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment -282%
3.82 [0.50-29.1]
11/216
1/75
-282% improvement All studies 50%
0.50 [0.05-5.45]
12/1,065
11/836
50% improvement 3 molnupiravir COVID-19 mortality results c19mp.com Jan 21, 2022
Tau2 = 2.97, I2 = 67.3%, p = 0.58
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) -33%
1.33 [0.14-12.5]
hosp.
3/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Tau2 = 0.34, I2 = 31.6%, p = 0.19
Early treatment 57%
0.43 [0.13-1.49]
10/511
24/432
57% improvement All studies 57%
0.43 [0.13-1.49]
10/511
24/432
57% improvement 2 molnupiravir COVID-19 hospitalization results c19mp.com Jan 21, 2022
Tau2 = 0.34, I2 = 31.6%, p = 0.19
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tau2 = 0.00, I2 = 0.0%, p = 0.0005
Early treatment 74%
0.26 [0.12-0.55]
8/1,220
33/1,131
74% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment -282%
3.82 [0.50-29.1]
11/216
1/75
-282% improvement All studies 58%
0.42 [0.11-1.66]
19/1,436
34/1,206
58% improvement 4 molnupiravir COVID-19 serious outcomes c19mp.com Jan 21, 2022
Tau2 = 1.04, I2 = 55.3%, p = 0.22
Effect extraction pre-specified
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Hetero (RCT) 33%
0.67 [0.54-0.82]
recov. time
371 (n)
370 (n)
Improvement, RR [CI] Treatment Control Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Tau2 = 0.13, I2 = 54.4%, p = 0.53
Early treatment 18%
0.82 [0.44-1.52]
8/383
3/376
18% improvement 033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI] Treatment Control 035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT) 1%
0.99 [0.68-1.45]
no recov.
72 (n)
75 (n)
Tau2 = 0.00, I2 = 0.0%, p = 0.97
Late treatment 1%
0.99 [0.74-1.34]
0/72
0/75
1% improvement All studies 15%
0.85 [0.66-1.11]
8/455
3/451
15% improvement 5 molnupiravir COVID-19 recovery results c19mp.com Jan 21, 2022
Tau2 = 0.03, I2 = 35.2%, p = 0.24
1 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 49%
0.51 [0.22-1.18]
viral+
10/118
9/54
Improvement, RR [CI] Treatment Control Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Tau2 = 0.00, I2 = 0.0%, p < 0.0001
Early treatment 57%
0.43 [0.32-0.58]
48/293
102/234
57% improvement Arribas (DB RCT) 12%
0.88 [0.62-1.25]
viral+
26/52
34/60
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.49
Late treatment 12%
0.88 [0.62-1.25]
26/52
34/60
12% improvement All studies 42%
0.58 [0.33-1.02]
74/345
136/294
42% improvement 3 molnupiravir COVID-19 viral clearance results c19mp.com Jan 21, 2022
Tau2 = 0.18, I2 = 79.2%, p = 0.058
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tau2 = 0.24, I2 = 53.7%, p = 0.013
Early treatment 55%
0.45 [0.24-0.85]
54/1,407
129/1,317
55% improvement 033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Improvement, RR [CI] Treatment Control 035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Tau2 = 0.00, I2 = 0.0%, p = 0.77
Late treatment -8%
1.08 [0.67-1.73]
11/216
1/75
-8% improvement All studies 34%
0.66 [0.38-1.13]
65/1,623
130/1,392
34% improvement 8 molnupiravir COVID-19 Randomized Controlled Trials c19mp.com Jan 21, 2022
Tau2 = 0.32, I2 = 65.6%, p = 0.13
Effect extraction pre-specified
1 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
0/140
1/62
Improvement, RR [CI] Treatment Control Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
1/709
9/699
Tau2 = 0.00, I2 = 0.0%, p = 0.024
Early treatment 86%
0.14 [0.02-0.78]
1/849
10/761
86% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
11/216
1/75
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment -282%
3.82 [0.50-29.1]
11/216
1/75
-282% improvement All studies 50%
0.50 [0.05-5.45]
12/1,065
11/836
50% improvement 3 molnupiravir COVID-19 RCT mortality results c19mp.com Jan 21, 2022
Tau2 = 2.97, I2 = 67.3%, p = 0.58
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Improvement, RR [CI] Treatment Control Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Tau2 = 0.95, I2 = 75.1%, p = 0.21
Early treatment 57%
0.43 [0.12-1.60]
16/1,092
35/1,075
57% improvement Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment -282%
3.82 [0.50-29.1]
11/216
1/75
-282% improvement All studies 36%
0.64 [0.18-2.24]
27/1,308
36/1,150
36% improvement 4 molnupiravir COVID-19 peer reviewed trials c19mp.com Jan 21, 2022
Tau2 = 1.11, I2 = 73.7%, p = 0.5
Effect extraction pre-specified
Favors molnupiravir
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Fischer (RCT) 77%
0.23 [0.01-5.69]
death
0/140
1/62
Improvement, RR [CI] Treatment Control Fischer (RCT) 65%
0.35 [0.01-8.33]
death
0/55
1/62
Fischer (RCT) 67%
0.33 [0.01-8.03]
death
0/62
1/62
Fischer (RCT) 58%
0.42 [0.02-10.0]
death
0/23
1/62
Fischer (RCT) -33%
1.33 [0.14-12.5]
hosp.
3/140
1/62
Fischer (RCT) -13%
1.13 [0.07-17.6]
hosp.
1/55
1/62
Fischer (RCT) -100%
2.00 [0.19-21.5]
hosp.
2/62
1/62
Fischer (RCT) 58%
0.42 [0.02-10.0]
hosp.
0/23
1/62
Fischer (RCT) 49%
0.51 [0.22-1.18]
viral+
10/118
9/54
Fischer (RCT) 89%
0.11 [0.01-0.86]
viral+
1/53
9/54
Fischer (RCT) 30%
0.70 [0.25-1.93]
viral+
5/43
9/54
Fischer (RCT) -9%
1.09 [0.37-3.18]
viral+
4/22
9/54
Fischer (RCT) 92%
0.08 [0.01-0.62]
viral+
1/117
6/54
Fischer (RCT) 92%
0.08 [0.00-1.34]
viral+
0/53
6/54
Fischer (RCT) 91%
0.09 [0.00-1.48]
viral+
0/42
6/54
Fischer (RCT) 59%
0.41 [0.05-3.20]
viral+
1/22
6/54
Fischer (RCT) 30%
0.70 [0.37-1.36]
viral+
19/137
12/61
Fischer (RCT) 62%
0.38 [0.13-1.12]
viral+
4/53
12/61
Fischer (RCT) -8%
1.08 [0.54-2.18]
viral+
13/61
12/61
Fischer (RCT) 56%
0.44 [0.11-1.83]
viral+
2/23
12/61
Hetero (RCT) 70%
0.30 [0.13-0.70]
hosp.
7/371
23/370
Hetero (RCT) 33%
0.67 [0.54-0.82]
recov. time
371 (n)
370 (n)
Optimus (RCT) 58%
0.42 [0.31-0.58]
viral+
38/175
93/180
Khoo (RCT) -33%
1.33 [0.55-3.26]
no recov.
8/12
3/6
Khoo (RCT) -100%
2.00 [0.28-14.2]
no recov.
4/12
1/6
Khoo (RCT) -100%
2.00 [0.90-4.43]
no recov.
4/4
3/6
Khoo (RCT) 0%
1.00 [0.28-3.54]
no recov.
2/4
3/6
Khoo (RCT) 0%
1.00 [0.28-3.54]
no recov.
2/4
3/6
Khoo (RCT) -50%
1.50 [0.13-17.7]
no recov.
1/4
1/6
Khoo (RCT) -200%
3.00 [0.39-23.1]
no recov.
2/4
1/6
Khoo (RCT) -50%
1.50 [0.13-17.7]
no recov.
1/4
1/6
Jayk Bernal (RCT) 89%
0.11 [0.01-0.86]
death
1/709
9/699
Jayk Bernal (RCT) 30%
0.70 [0.49-0.99]
hosp./death
48/709
68/699
Jayk Bernal (RCT) 94%
0.06 [0.00-0.97]
hosp./death
0/37
9/47
Jayk Bernal (RCT) 50%
0.50 [0.20-1.26]
hosp./death
6/75
13/82
Jayk Bernal (RCT) 24%
0.76 [0.42-1.38]
hosp./death
18/237
22/221
Jayk Bernal (RCT) 42%
0.58 [0.20-1.68]
hosp./death
5/47
7/38
033864 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
035424 (RCT) 0%
1.00 [0.50-2.00]
improv.
n/a
n/a
FUTILITY, PENDING1
Arribas (DB RCT) -282%
3.82 [0.50-29.1]
death
11/216
1/75
Arribas (DB RCT) -217%
3.17 [0.34-29.8]
death
3/71
1/75
Arribas (DB RCT) -317%
4.17 [0.48-36.4]
death
4/72
1/75
Arribas (DB RCT) -311%
4.11 [0.47-35.9]
death
4/73
1/75
Arribas (DB RCT) 1%
0.99 [0.68-1.45]
no recov.
72 (n)
75 (n)
Arribas (DB RCT) 12%
0.88 [0.61-1.28]
no recov.
73 (n)
75 (n)
Arribas (DB RCT) -1%
1.01 [0.69-1.47]
no recov.
73 (n)
75 (n)
Arribas (DB RCT) 12%
0.88 [0.62-1.25]
viral+
26/52
34/60
Arribas (DB RCT) -2%
1.02 [0.74-1.41]
viral+
29/50
34/60
Arribas (DB RCT) 21%
0.79 [0.56-1.13]
viral+
27/60
34/60
Arribas (DB RCT) 8%
0.92 [0.41-2.08]
viral+
9/53
10/54
Arribas (DB RCT) -48%
1.48 [0.72-3.03]
viral+
14/51
10/54
Arribas (DB RCT) 21%
0.79 [0.34-1.84]
viral+
8/55
10/54
molnupiravir COVID-19 outcomes c19mp.com Jan 21, 2022
1 FUTILITY: terminated for futility, results pending Favors molnupiravir
Favors control
Please send us
corrections, updates, or comments. Vaccines and treatments are both
valuable and complementary. All practical, effective, and safe means
should be used. Elimination of COVID-19 is a race against viral evolution. No
treatment, vaccine, or intervention is 100% available and effective for all
current and future variants. Denying the efficacy of any method increases
mortality, morbidity, collateral damage, and the risk of endemic status. We do
not provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
WCH
and
FLCCC provide
treatment protocols.
Thanks for your feedback! Please search before submitting papers and note
that studies are listed under the date they were first available, which may be
the date of an earlier preprint.
Submit
