| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Clinical improvement
D28 |
Outcome not yet measured or reported
|
|
Clinical improvement
D60 |
Outcome not yet measured or reported
|
|
Hospitalisation or death
|
RR: 0.13
(0.07 - 0.27) |
53 fewer per 1000
(from 56 fewer to 44 fewer)
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
Multicentre study conducted across several countries, therefore not downgraded for indirectness Imprecision: Serious
due to wide confidence interval consistent with the possibility for benefit and the possibility for no effect/trivial effect
|
| 1 trials
Hammond J, 2022
2246 participants
|
|
Nirmatrelvir/ritonavir
8 per 1,000
(4 - 16) |
Placebo
60
per 1,000 |
|
WHO progression score (level 7 or above)
D28 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
|
All-cause mortality
D28 |
RR: 0.04
(0.00 - 0.63) |
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
Multicentre study conducted across several countries, therefore not downgraded for indirectness Imprecision: Serious
due to low number of participants/events
|
| 1 trials
Hammond J, 2022
2246 participants
|
|
Nirmatrelvir/ritonavir
0 per 1,000
( - ) |
Placebo
0
per 1,000 |
|
All-cause mortality
D60 |
Outcome not yet measured or reported
|
|
Viral negative conversion
D7 |
Outcome not yet measured or reported
|
|
Adverse events
|
RR: 0.95
(0.82 - 1.10) |
12 fewer per 1000
(from 43 fewer to 24 more)
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings, therefore not downgraded for indirectness Imprecision: Serious
due to low number of participants/events
|
| 1 trials
Hammond J, 2022
2246 participants
|
|
Nirmatrelvir/ritonavir
224 per 1,000
(194 - 260) |
Placebo
236
per 1,000 |
|
Serious adverse events
|
RR: 0.24
(0.15 - 0.41) |
50 fewer per 1000
(from 56 fewer to 39 fewer)
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings, therefore not downgraded for indirectness Imprecision: Serious
due to low number of participants/events
|
| 1 trials
Hammond J, 2022
2246 participants
|
|
Nirmatrelvir/ritonavir
16 per 1,000
(10 - 27) |
Placebo
66
per 1,000 |
|
1The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
