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Meta-Analysis
. 2024 Apr;12(4):e1262.
doi: 10.1002/iid3.1262.

Comparison of effectiveness and safety of molnupiravir versus sotrovimab for COVID-19: A systematic review and meta-analysis

Bahman Amani  1 , Behnam Amani  1
Affiliations
Meta-Analysis

Comparison of effectiveness and safety of molnupiravir versus sotrovimab for COVID-19: A systematic review and meta-analysis

Bahman Amani et al. Immun Inflamm Dis. 2024 Apr.

Abstract

Background and aim: This systematic review and meta-analysis aimed to compare the effectiveness and safety of molnupiravir and sotrovimab in the treatment of patients with coronavirus disease 2019 (COVID-19).

Methods: Cochrane Library, Web of Science, PubMed, medRxiv, and Google Scholar were systematically searched to identify relevant evidence up to December 2023. The risk of bias was assessed using the risk of bias in nonrandomized studies of interventions tool. Data were analyzed using Comprehensive Meta-Analysis (CMA).

Results: Our search identified and included 13 studies involving 16166 patients. The meta-analysis revealed a significant difference between the molnupiravir and sotrovimab groups in terms of the mortality rate (odds ratio [OR] = 2.07, 95% confidence interval [CI]: 1.16, 3.70). However, no significant difference was observed between the two groups in terms of hospitalization rate (OR = 0.71, 95% CI: 0.47, 1.06), death or hospitalization rate (OR = 1.51, 95% CI: 0.81, 2.83), and intensive care unit admission (OR = 0.59, 95% CI: 0.07, 4.84). In terms of safety, molnupiravir was associated with a higher incidence of adverse events (OR = 1.67, 95% CI: 1.21, 2.30).

Conclusion: The current findings indicate that sotrovimab may be more effective than molnupiravir in reducing the mortality rate in COVID-19 patients. However, no statistical difference was observed between the two treatments for other effectiveness outcomes. The certainty of evidence for these findings was rated as low or moderate. Further research is required to provide a better comparison of these interventions in treating COVID-19 patients.

Keywords: COVID‐19; SARS‐CoV‐2; effectiveness; molnupiravir; safety; sotrovimab.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of PRISMA. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta‐Analyses.
Figure 2
Figure 2
Forest plot of molnupiravir versus sotrovimab for mortality rate. CI, confidence interval.
Figure 3
Figure 3
Forest plot of molnupiravir versus sotrovimab for hospitalization rate. CI, confidence interval.
Figure 4
Figure 4
Forest plot of molnupiravir versus sotrovimab for death or hospitalization rate. CI, confidence interval.
Figure 5
Figure 5
Forest plot of molnupiravir versus sotrovimab for intensive care unit admission. CI, confidence interval.
Figure 6
Figure 6
Forest plot of molnupiravir versus sotrovimab for adverse events. CI, confidence interval.
See this image and copyright information in PMC

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