Comparing the effectiveness of molnupiravir and nirmatrelvir‐ritonavir in non‐hospitalized and hospitalized COVID ‐19 patients with type 2 diabetes:   A target trial emulation study

Eric Y. F. Wan; Zoey C. T. Wong; Vincent K. C. Yan; Celine S. L. Chui; Francisco T. T. Lai; Xue Li; Ian C. K. Wong; Esther W. Y. Chan

doi:10.1111/dom.15830

Comparing the effectiveness of molnupiravir and nirmatrelvir‐ritonavir in non‐hospitalized and hospitalized COVID ‐19 patients with type 2 diabetes: A target trial emulation study

Eric Y. F. Wan, Zoey C. T. Wong, Vincent K. C. Yan, Celine S. L. Chui, Francisco T. T. Lai, Xue Li, Ian C. K. Wong^*, Esther W. Y. Chan^*

^*Corresponding author for this work

Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
The University of Hong Kong, Shenzhen Institute of Research and Innovation, Shenzhen, China.

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

34 Downloads (Pure)

Abstract

Aims: To compare the effectiveness of molnupiravir and nirmatrelvir‐ritonavir for non‐hospitalized and hospitalized COVID‐19 patients with type 2 diabetes (T2DM). Materials and Methods: Territory‐wide electronic health records in Hong Kong were used to perform target trial emulation using a sequential trial approach. Patients (1) aged ≥18 years, (2) with T2DM, (3) with COVID‐19 infection, and (4) who received molnupiravir or nirmatrelvir‐ritonavir within 5 days of infection between 16 March 2022 and 31 December 2022 in non‐hospital and hospital settings were included. Molnupiravir and nirmatrelvir‐ritonavir initiators were matched using one‐to‐one propensity‐score matching and followed for 28 days. Risk of outcomes was compared between groups by Cox regression adjusted for baseline characteristics. Subgroup analyses were performed on age (

Original language	English
Pages (from-to)	4653-4664
Number of pages	12
Journal	Diabetes, Obesity and Metabolism
Volume	26
Issue number	10
Early online date	7 Aug 2024
DOIs	https://doi.org/10.1111/dom.15830
Publication status	Published - Oct 2024

Bibliographical note

Published CC BY NC

Publisher Copyright:
© 2024 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Data Access Statement

Data are not available as the data custodians (the Hospital Authority and the Department of Health of Hong Kong SAR) have not given permission for sharing due to patient confidentiality and privacy concerns. Local academic institutions, government departments, or non-governmental organizations may apply for the access to data through the Hospital Authority's data sharing portal (https://www3.ha.org.hk/data).

Funding

This work was supported by HMRF Research on COVID\u201019, the HKSAR Government (Principal Investigator [WP2]: Esther W. Y. Chan; ref no. COVID1903011), the Collaborative Research Fund, University Grants Committee, the HKSAR Government (Principal Investigator: Ian C. K. Wong; ref. no. C7154\u201020GF), and a research grant from the Food and Health Bureau, the HKSAR Government (Principal Investigator: Ian C. K. Wong; ref. no. COVID19F01). Ian C. K. Wong and Francisco T. T. Lai are partially supported by the Laboratory of Data Discovery for Health (D4H) funded by the by AIR@InnoHK administered by Innovation and Technology Commission. We gratefully acknowledge the Centre for Health Protection, the Department of Health and the Hospital Authority for facilitating data access.

Funders	Funder number
Shanghai Key Laboratory of Meteorology and Health
Guangzhou Science, Technology and Innovation Commission
Research Grants Council, University Grants Committee	C7154‐20GF
Nanjing Municipal Health Bureau	COVID19F01

Keywords

effectiveness
pharmacoepidemiology
real-world evidence
type 2 diabetes

Access to Document

10.1111/dom.15830

Comparing the effectiveness of molnupiravir and nirmatrelvir-ritonavir in non-hospitalized and hospitalized COVID-19 patients with type 2 diabetes: A target trial emulation studyFinal published version, 1.08 MBLicence: CC BY-NC 4.0

Cite this

Wan, E. Y. F., Wong, Z. C. T., Yan, V. K. C., Chui, C. S. L., Lai, F. T. T., Li, X., Wong, I. C. K., & Chan, E. W. Y. (2024). Comparing the effectiveness of molnupiravir and nirmatrelvir‐ritonavir in non‐hospitalized and hospitalized COVID ‐19 patients with type 2 diabetes: A target trial emulation study. Diabetes, Obesity and Metabolism, 26(10), 4653-4664. https://doi.org/10.1111/dom.15830

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abstract = "Aims: To compare the effectiveness of molnupiravir and nirmatrelvir‐ritonavir for non‐hospitalized and hospitalized COVID‐19 patients with type 2 diabetes (T2DM). Materials and Methods: Territory‐wide electronic health records in Hong Kong were used to perform target trial emulation using a sequential trial approach. Patients (1) aged ≥18 years, (2) with T2DM, (3) with COVID‐19 infection, and (4) who received molnupiravir or nirmatrelvir‐ritonavir within 5 days of infection between 16 March 2022 and 31 December 2022 in non‐hospital and hospital settings were included. Molnupiravir and nirmatrelvir‐ritonavir initiators were matched using one‐to‐one propensity‐score matching and followed for 28 days. Risk of outcomes was compared between groups by Cox regression adjusted for baseline characteristics. Subgroup analyses were performed on age (",

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author = "Wan, {Eric Y. F.} and Wong, {Zoey C. T.} and Yan, {Vincent K. C.} and Chui, {Celine S. L.} and Lai, {Francisco T. T.} and Xue Li and Wong, {Ian C. K.} and Chan, {Esther W. Y.}",

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Wan, EYF, Wong, ZCT, Yan, VKC, Chui, CSL, Lai, FTT, Li, X, Wong, ICK & Chan, EWY 2024, 'Comparing the effectiveness of molnupiravir and nirmatrelvir‐ritonavir in non‐hospitalized and hospitalized COVID ‐19 patients with type 2 diabetes: A target trial emulation study', Diabetes, Obesity and Metabolism, vol. 26, no. 10, pp. 4653-4664. https://doi.org/10.1111/dom.15830

Comparing the effectiveness of molnupiravir and nirmatrelvir‐ritonavir in non‐hospitalized and hospitalized COVID ‐19 patients with type 2 diabetes: A target trial emulation study. / Wan, Eric Y. F.; Wong, Zoey C. T.; Yan, Vincent K. C. et al.
In: Diabetes, Obesity and Metabolism, Vol. 26, No. 10, 10.2024, p. 4653-4664.

Research output: Contribution to journal › Article › peer-review

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