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Paxlovid: You'd have expected more

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Re: Paxlovid: You'd have expected more

#81

Post by moshegramovsky »

chefandy wrote: post #21
moshegramovsky wrote: post #8

I have quite a bit of anecdata that Paxlovid works very well in helping very sick elderly people stay out of the hospital.

I’ve had Covid 5 times— I’m pretty familiar with how it progresses. The most recent time was the most severe— I went to the ER with a temp of 103 with ibuprofen. Got Paxlovid— the major symptoms nearly switched off like flipping a light switch. Of course there’s a possibility it would have done that anyway, but I’m sure as hell going to take it again if necessary.

I definitely will take it again, no question. It worked really well for me. Side effects weren't too bad either.

Re: Paxlovid: You'd have expected more

#82

Post by moshegramovsky »

jgalt212 wrote: post #13
moshegramovsky wrote: post #8

I have quite a bit of anecdata that Paxlovid works very well in helping very sick elderly people stay out of the hospital.

Yes, but these drugs (and the vaccines) don't make nearly as much money if only taken by those with high risk profiles.

The copays were pretty expensive! On the order of $400.00.

Re: Paxlovid: You'd have expected more

#83

Post by moshegramovsky »

monktastic1 wrote: post #14
moshegramovsky wrote: post #10

Earlier quoted context omitted.

Same. I had one night of fever and incredible chills. Thought for sure I was going to get very sick. Got Paxlovid next day. Felt better the following day. It was like having a cold, and I don't think that would have happened without the Paxlovid.

I also had one night of fever and incredible chills, followed by two days of no symptoms. No Paxlovid. (But then I did get bad cold-like symptoms for a week, and what seems to be long Covid...)

Sorry you got long covid. I hope you recover quickly!

Re: Paxlovid: You'd have expected more

#85

Post by HocusLocus »

temporallobe wrote: post #33

My father almost died on Paxlovid. Almost immediately after taking it, he ended up in the ER, complaining of cardiac issues (severe arrhythmias and pain) and saying he felt like death. It wasn’t exactly a cardiac arrest, rather an “event”. While one could say it was Covid, the timing of the symptoms were too coincidental to ignore. It took him 2 months to start feeling normal. He had had covid twice before and was su…

I upvoted because you were gray, apparently wrongthink was being thunk by you. That's pretty sick.

MY father, 83 and stable on his meds for years, died 10 days after his first Moderna. COVID tested negative, pulmonary thrombosis. I didn't think that was a coincidence at all, hell no. I'm glad your dad is all right. Let's all try to avoid these coincidences in the future. Maybe my post will be flagged as wrongthink too, it's become a badge of honor at this point.

Re: Paxlovid: You'd have expected more

#86

Post by mannyv »

jimmydoe wrote: post #74
reify wrote: post #25

GoodRX, Paxlovid ranges from $1,497 at CVS to $1,696 at Costco. Fuck me! Only for rich muppets then? In my local Boots chemist Aspirin is about £2.00 for 28 tablets. Paxlovid is a combination of 2 medicines called nirmatrelvir and ritonavir. Nirmatrelvir stops the virus from growing and spreading, and ritonavir helps nirmatrelvir from being broken down in your body long enough to do its job. Fuck me! again.

for poor people like me, the cost made me hesitate, then the best timing of taking it was gone. so if banning this med is the only way to make the world more equal, I'm all for it.

You would rather have everyone be worse off than a few be better off?

Re: Paxlovid: You'd have expected more

#87

Post by credit_guy »

I love Derek Lowe as much as anyone else, but this piece is a bit weak.

The (currently) first comment on his site is right on point:

  > I don’t really see what point this article is trying to make. I’m 65. Vaxxed for covid to the max. Finally got covid. Before I had much in the way of symptoms I took Paxlovid for 5 days. Covid symptoms stopped. Tested clear of Covid after 5 days. Then I had rebound Covid for about a week but it was mild. If I ever get Covid again I’ll take paxlovid again. I don’t care what anyone else thinks.
Here are some reasons the article is weak.

1. I'll start with my own anecdote. I got the initial 2 shots of Moderna and later the booster when it became available. Still, I contracted Covid in early 2022 and it was not very fun. Then I contracted Covid in early 2024 and I got Paxlovid this time, and it was a breeze.

2. The mechanism of action of Paxlovid is different from the mechanism of action of the Pfizer/Moderna vaccines (I guess other vaccines as well). The vaccines train the body to recognize the spike protein of the virus, while Paxlovid attacks a protease (called M-pro) that plays some role in the virus's replication cycle. As the Covid virus mutates and the vaccines bases on the older strains become less effective, the added benefit of a drug with a different mechanism of action increases. Note that I said the added benefit, not the absolute benefit, which could very well decrease too. So, a study based on observations between April and October 2022 is likely to understate the benefit of Paxlovid today (for the vaccinated people).

3. Derek does not mention if the study was powerful enough. Absence of evidence is not evidence of absence. Since this was an observational study based on an existing cohort, the observers did not have a chance to do design the experiment to ensure enough statistical power. The conclusion that Derek draws is based on multiple indirect comparisons, and in all of them Derek treats statistical insignificance as equality.

4. Derek talks about long term effects. In my own anecdote, I did suffer from hearing loss for many months after my Covid episode with no Paxlovid. Nothing close to getting me to a hospital. But very annoying. Absolutely no Covid short or long term effects when I took Paxlovid.

5. This statement "if a drug's not doing you any good then you really shouldn't take it at all" is a big error. Derek jumped from "we have no evidence that the drug is good" to "the drug is doing you no good". Boom. Blink and you don't see it.

Re: Paxlovid: You'd have expected more

#88

Post by thenerdhead »

jerlam wrote: post #66
thenerdhead wrote: post #55

Earlier quoted context omitted.

there are a number of computational/modeling studies suggesting paxlovid needs to be given for at least 7+ days to slow the viral load and prevent rebound. Pfizer did a preliminary study(the FDA asked them) and quietly published their results on the topic. their data implies a second treatment might shorten the overall duration of the infection consistent with the studies i allude to above. but you probably haven't h…

The Paxlovid dosing guidelines probably need to be changed, but given the current climate and cost it's unlikely to ever happen. Similarly, the initial two-shot vaccine guidelines probably needed more time in between the doses for more effectiveness, but that's what was tested so that's the official recommendation.

agreed on changing guidelines, disagree its unlikely to happen.

the study is done and just needs to be formally published. then recommendations can "officially" change although the science has been clear about this for quite some time now with this specific drug.

other antivirals dont have this problem because they are actually effective for 10+ days even if you take it for 5 days (Ensitrelvir).

there's countless candidates in the pipeline as well for vaccines, antivirals, and monoclonal antibodies. as they keep getting better, the guidelines will shift slowly but surely.

i personally wish we did this with more urgency.

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