New oral analogue to remdesivir is similarly effective to nirmatrelvir-ritonavir for mild to moderate symptomatic COVID-19

Clinical Question

Is the novel oral antiviral drug VV116 noninferior to nirmatrelvir-ritonavir (Paxlovid) for high-risk patients with symptomatic mild to moderate COVID-19?

Bottom line

A new oral analogue to remdesivir provided a similar time to sustained clinical recovery as nirmatrelvir-ritonavir (Paxlovid). There was no placebo group and the vast majority of patients had mild disease, with no patients progressing to severe disease or dying. It is good to have an alternative to Paxlovid that is easier to take than intravenous remdesivir. The drug is manufactured by a Chinese drug company and has not been submitted for FDA approval, but this study highlights the fact that more drugs for COVID-19 (and probably other viral infections) are on their way. 1b

Study design: Randomized controlled trial (double-blinded)

Funding: Industry + govt

Setting: Outpatient (any)


Mark H. Ebell, MD, MS
University of Georgia
Athens, GA

Discuss this POEM


Arup Kumar Dhara

Impact assessment



Oral Analogue too Remdesivir

Why would pts with mild Covid symptoms be hospitalised? Were they already hospitalised for co-morbidities & Covid was coincidental or nosocomial? Why would mild viral symptoms require intensive treatment?

The lack of a placebo group further questions the value of the study - as well as the mean age of the 53 yrs pt group not being the most likely to experience disease progression.