Lagevrio (molnupiravir) / Emory University, Ridgeback Biotherap, Merck (MSD), Cipla - LARVOL DELTA

Effectiveness comparison of nirmatrelvir/ritonavir versus molnupiravir in COVID-19 patients with comorbidities in Taiwan: a multi-centre electronic health record study. (PubMed, BMC Infect Dis) - "Data revealed that both nirmatrelvir/ritonavir and molnupiravir demonstrated clinical benefits in treating COVID-19 patients in a real-world setting. Moreover, nirmatrelvir/ritonavir was associated with a lower risk of mortality in COVID-19 patients with specific circumstances."

Journal • Chronic Kidney Disease • CNS Disorders • Diabetes • Hepatology • Infectious Disease • Mental Retardation • Metabolic Disorders • Nephrology • Novel Coronavirus Disease • Psychiatry • Renal Disease • Respiratory Diseases

Factors associated with seeking and receiving home antiviral therapy during the coronavirus disease 2019 (COVID-19) pandemic. (PubMed, Discov Public Health) - "Home antiviral treatment (HAVT: nirmatrelvir/ritonavir [Paxlovid] and molnupiravir [Lagevrio]) for COVID-19 was approved in December 2021 by the U.S. Food and Drug Administration, but ensuing utilization during the Coronavirus Disease 2019 (COVID-19) pandemic was low. Loss of taste or smell was the most important factor among several others associated with seeking HAVT irrespective of COVID-19 test status. The online version contains supplementary material available at 10.1186/s12982-025-01192-3."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

In vivo pharmacokinetic evaluation of molnupiravir in patients with severe chronic kidney disease. (PubMed, Front Pharmacol) - "The NHC is significantly higher than that of patients with mild to moderate symptoms, especially those with stage 5 chronic kidney disease. The blood drug concentration is equivalent to Cmax, which suggests that when used clinically in patients with uremia, the dosing interval should be adjusted to avoid drug accumulation and occurrence of AEs."

Journal • PK/PD data • Preclinical • Chronic Kidney Disease • Infectious Disease • Nephrology • Novel Coronavirus Disease • Renal Disease • Respiratory Diseases

Acute T-Cell Rejection after Living-Donor Kidney Transplantation: Monitoring with Urinary Presepsin. (PubMed, Cureus) - "A standard immunosuppressive protocol was administered with steroids, basiliximab, mycophenolate mofetil (MMF), and tacrolimus. On postoperative day 5, he contracted COVID-19 and was treated with molnupiravir; however, antigen positivity persisted, leading to a reduction in MMF...Urinary presepsin levels at the time of TCMR and at the three-month and one-year protocol biopsies were 13,075, 1,332, and 680 ng/g creatinine, respectively, correlating with changes in renal function and histological findings. This case suggests that urinary presepsin may be a valuable noninvasive biomarker for monitoring disease activity in TCMR."

Journal • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Infectious Disease • Novel Coronavirus Disease • Transplantation

EXPRESS: Early Blood RNA Clearance and Protein Fraction Profiles Predict Treatment Outcomes in Cats with Effusive FIP. (PubMed, J Feline Med Surg) - "Antiviral treatment included GS-441524, remdesivir, molnupiravir, or adjunctive nirmatrelvir. Persistence of blood viral RNA 2 weeks after treatment, together with opposing changes in α2- and γ-Glb fractions, emerged as predictors of treatment outcomes.Conclusions and relevanceBaseline blood N gene RNA loads and serum Glb fractions have potential as early prognostic indicators in effusive FIP. These results support combining viral and host biomarkers to improve predictions and monitoring."

Journal • Hematological Disorders • Infectious Disease • Novel Coronavirus Disease

Treatment of Non-severe COVID-19 with Molnupiravir: A Systematic Review with Meta-analysis and Trial Sequential Analysis of the Evidence from Randomized Controlled Trials. (PubMed, Clin Drug Investig) - "Notwithstanding a paucity of RCTs, our findings suggest that molnupiravir may only be efficacious for clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; the virus responsible for COVID-19) in adults with nonsevere COVID-19 although the evidence is not sufficient for conclusions to be drawn. More high quality RCTs are needed for a stronger evidence base."

Journal • Retrospective data • Review • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Template switching by coronavirus polymerase requires helicase activity and is stimulated by remdesivir and molnupiravir. (PubMed, bioRxiv) - "We propose a novel mechanism of action where incorporation of these analogs dramatically reduces full length genome copy number by stimulating polymerase template switching. Our study further demonstrates nsp13-helicase's central role in CoV replication and how this enzyme function can be indirectly targeted by analogs."

Journal • Infectious Disease • Novel Coronavirus Disease

Allosteric Inhibitors of SARS-CoV-2 RNA-Dependent RNA Polymerase Based on N,N'-Diphenylurea. (PubMed, ChemMedChem) - "To date, only a few such agents, including molnupiravir and remdesivir, have been approved by the FDA. Despite these improvements, cytotoxicity remains a limitation across the series. These findings provide valuable structure-activity relationship insights and direct ongoing optimization efforts toward developing less toxic, soluble RdRp inhibitors with improved antiviral profiles."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Nirmatrelvir/Ritonavir Reduces Infection Duration in Hospitalized Hematological Malignancies Patients with Mild-to-Moderate COVID-19: A Retrospective Study (ASH 2024) - P=N/A | "Patients diagnosed with severe COVID-19, or treated with convalescent plasma, azvudine, or molnupiravir, or with unknown vaccination status, were excluded. Other treatment regimens did not achieve a statistically significant difference in time to viral clearance. Nirmatrelvir/ritonavir use within five days reduced the time to viral clearance (HR=1.51, 95% CI 1.01-2.23).ConclusionsNirmatrelvir/ritonavir use within five days in hospitalized HM patients with mild-to-moderate COVID-19 does not reduce mortality but shortens infection duration."

Retrospective data • Acute Myelogenous Leukemia • Hematological Malignancies • Infectious Disease • Leukemia • Lymphoma • Myelodysplastic Syndrome • Non-Hodgkin’s Lymphoma • Oncology • Respiratory Diseases

EXPRESS: Clinical trial of molnupiravir with or without an oral immune stimulant as a first-line treatment of feline infectious peritonitis. (PubMed, J Feline Med Surg) - "These results support those of others showing that molnupiravir is an effective treatment for cats diagnosed with FIP. Additional studies will be required to determine if any benefits might be derived from the LTC treatment."

Journal • Infectious Disease • Novel Coronavirus Disease

Sustainable electrochemical platform for monitoring COVID-19 therapeutics based on copper-cobalt-ferrite nanoparticles. (PubMed, Talanta) - "Molnupiravir (MPV) is used to reduce the risk of COVID-19 progression by inhibiting SARS-CoV-2 replication. Because MPV is frequently co-administered with linezolid (LIN) and apixaban (APIX) in COVID-19 therapy, we introduce here, for the first time, a simple electrochemical method for their simultaneous determination in spiked human plasma using a nanoparticle-modified sensor. The method's environmental impact was further assessed using the Analytical Eco-Scale, Green Analytical Procedure Index (GAPI), and the Analytical GREEnness Metric Approach (AGREE), all confirming the sustainability of the developed protocol."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

WITHDRAWN Molnupiravir provides therapeutic protection to nonhuman primates aerosol exposed to Venezuelan equine encephalitic virus (ASTMH 2025) - "Lastly, evaluation of EIDD-2801 in the aerosol VEEV INH-9813 NHP model found that 150 mg/kg of EIDD-2801 (+12hrs, PO, BID, 7 days) was able to reduce the hallmarks of human VEEV disease (fever, viremia, and lymphopenia) to statistically significant levels in treated versus control NHPs. This is the first successful demonstration of a small molecule therapeutic against VEEV in the NHP model."

Late-breaking abstract • Chikungunya • CNS Disorders • Ebola Virus Disease • Hepatology • Infectious Disease • Inflammation • Influenza • Musculoskeletal Pain • Novel Coronavirus Disease • Respiratory Diseases

Selinexor, Daratumumab and Dexamethasone for Patients with Multiple Myeloma Previously Treated with Lenalidomide at First Relapse: A Real-World Study (ASH 2023) - P | "Three pts received antiviral medication (two with Paxlovid and one with Molnupiravir), and three recovered, but the one with MOF died. This real-world study demonstrates that SDd combination therapy led to early, deep responses in lenalidomide-refractory multiple myeloma patients at their first relapse. Considering that patients with extramedullary disease had limited benefit from SDd treatment, future study designs may restrict the recruitment of such patients."

Clinical • IO biomarker • Real-world • Real-world evidence • Anemia • Cough • Hematological Malignancies • Infectious Disease • Multiple Myeloma • Neutropenia • Pneumonia • Respiratory Diseases • Thrombocytopenia • XPO1

Catching Cache Valley Virus: Immunodeficiency and Ikaros Variants (ACAAI 2025) - "He received six months of molnupiravir with subsequent viral clearance...This case outlines the importance of an immune work up for patients presenting with rare viral meningoencephalitis or in the context of presumed autoimmunity. Furthermore, the case highlights the importance of repeating genetic testing in the setting of prior inconclusive results."

CNS Disorders • Hematological Disorders • Immune Thrombocytopenic Purpura • Immunology • Infectious Disease • Primary Immunodeficiency • Thrombocytopenic Purpura • IKZF1

Structure-Informed Design of High-Cooperativity PROTAC Targeting SARS-CoV-2 RdRp via Click Chemistry and Enhanced Sampling Simulations. (PubMed, J Med Chem) - "Our integrated pipeline identified PROTAC 10, a molnupiravir-CRBN conjugate, which demonstrated high-affinity binding (Kd = 1.09 nM), pronounced positive cooperativity (α = 45.9), and effective CRBN-mediated RdRp degradation (DC50 = 1.97 μM) in infected cells...Molecular dynamics simulations revealed that its engineered linker enhances cooperativity, ternary complex stability (ΔGTER = -247 kcal/mol), and chameleonic character. This study provides a strategic framework to design antiviral PROTACs through rational linker optimization that enables selective viral protein degradation."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • Targeted Protein Degradation • CRBN

Molnupiravir: Clinical Impact of Fenofibrate, a Carboxylesterase 2 Inhibitor. (PubMed, Am J Ther) - No abstract available

Journal

Effectiveness of Nirmatrelvir/Ritonavir or Molnupiravir Use in Immunocompromised Patients on B-Cell-Depleting Therapy With COVID-19: A Target Trial Emulation Study. (PubMed, Clin Infect Dis) - "Early outpatient nirmatrelvir/ritonavir significantly lowers the risk of COVID-19-related hospitalization or death in patients on BCDT. Molnupiravir showed a nonsignificant trend toward benefit. These findings support prioritizing nirmatrelvir/ritonavir for high-risk immunocompromised populations."

Journal • Infectious Disease • Inflammation • Novel Coronavirus Disease • Respiratory Diseases

An exploratory binding study of molnupiravir efficacy against emerging Omicron SARS-CoV-2 variants. (PubMed, Sci Rep) - "The results highlighted the crucial function of protein loops in offering flexibility and enabling ligand binding within the active site. It is concluded that Molnupiravir has the potential to function as an inhibitor of both omicron and its subvariant BQ.1.1."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Impact of baseline humoral immunity on treatment outcomes with molnupiravir in the MOVe-OUT randomized, controlled trial. (PubMed, Virology) - P2/3 | "Anti-SARS-CoV-2 antibodies at baseline, more common with placebo, provided protection against poor clinical outcomes. Potentially undisclosed vaccination unlikely impacted the overall trial outcomes. Molnupiravir treatment did not significantly affect development of humoral immunity to SARS-CoV-2 infection."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Association of Oral Outpatient Antiviral Medications for COVID-19 with the Risk of Post-acute Sequelae of COVID-19 in Individuals with Systemic Autoimmune Rheumatic Diseases (ACR Convergence 2025) - "Individuals who were hospitalized for acute COVID-19 and/or who received COVID-19 monoclonal antibodies or remdesivir were excluded...We assessed the odds of PASC at both 28 and 90 days following COVID-19 infection and used multivariable logistic regression to compare those who did versus did not receive oral outpatient antiviral medication (either nirmatrelvir/ritonavir or molnupiravir) for acute COVID-19 infection... In this prospective contemporary cohort, individuals with SARDs who received oral outpatient antiviral therapy had significantly lower odds of PASC lasting at least 90 days following COVID-19 infection than those who did not receive antiviral therapy, while odds of PASC lasting at least 28 days did not differ between groups. These findings support additional potential benefits of oral outpatient antiviral treatment for PASC risk among individuals with SARDs who are eligible and do not have contraindications."

Clinical • Immunology • Infectious Disease • Inflammatory Arthritis • Novel Coronavirus Disease • Rheumatology • CD20

Molnupiravir for treating COVID-19. (PubMed, Cochrane Database Syst Rev) - "In outpatients with mild to moderate COVID-19, molnupiravir 800 mg taken orally every 12 hours for five days probably results in little to no difference in all-cause mortality and may result in little to no difference in rates of hospitalisation and symptom resolution. There is evidence of increased viral clearance by day 5, but the clinical relevance of this finding is unclear. There is probably little to no difference in adverse events, and there is little to no difference in serious adverse events, with molnupiravir versus placebo or standard care. Inpatient data are lacking, and there is no evidence of benefit of molnupiravir in this population. Further research involving inpatients may change this."

Clinical • Journal • Review • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Multi spectroscopic investigations with molecular docking and molecular dynamics simulation of the binding mechanism of molnupiravir to bovine serum albumin. (PubMed, BMC Chem) - "These findings were further confirmed by the molecular docking and MD simulation studies. This research could provide valuable insights into the pharmacokinetics and pharmacodynamics of MOL, which could contribute to the development of more effective antiviral drugs."

Journal • Infectious Disease • Novel Coronavirus Disease

Challenges in the Treatment of HIV-Related Lymphomas Complicated by COVID-19: Case Study and Review of the Literature. (PubMed, Pharmaceuticals (Basel)) - "Despite administration of molnupiravir, both SARS-CoV-2 antigen and RT-qPCR tests remained positive for a minimum of 113 days. The prolonged SARS-CoV-2 infection, in conjunction with other opportunistic infections, impeded the delivery of adequate chemotherapy dose intensity and contributed to disease progression and ultimately the patient's death. This case and review of the literature underscores the diversity of the clinical course of SARS-CoV-2 infection in patients with ARL and highlights the associated challenges in delivering optimal anti-lymphoma therapy in those patients."

Journal • Review • B Cell Lymphoma • Diffuse Large B Cell Lymphoma • Epstein-Barr Virus Infections • Hematological Malignancies • Human Immunodeficiency Virus • Infectious Disease • Lymphoma • Non-Hodgkin’s Lymphoma • Novel Coronavirus Disease • Oncology • Respiratory Diseases

Efficacy of Oseltamivir Against Seasonal Influenza H1N1 and the Efficacy of a Novel Combination Treatment In Vitro and In Vivo in Mouse Studies. (PubMed, Influenza Other Respir Viruses) - "The increase in HA and NA activities of seasonal influenza reduced the efficacy of oseltamivir treatment, but the effectiveness of molnupiravir and baloxavir was retained. Combination therapy showed a significant antiviral effect, which provides a reference for the clinical treatment."

Journal • Preclinical • Infectious Disease • Inflammation • Influenza • Pneumonia • Respiratory Diseases

Comparing the Effectiveness and Safety of Remdesivir and Molnupiravir in COVID-19: A Systematic Review and Meta-Analysis. (PubMed, Immun Inflamm Dis) - "The findings of this study suggest that remdesivir and molnupiravir have similar effectiveness in treating COVID-19 outpatients; however, molnupiravir is associated with a higher rate of adverse events. Additional studies are required to enable a more thorough evaluation of these treatments for COVID-19."

Clinical • Journal • Retrospective data • Review • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases