{"doi":"10.1093/ckj/sfad184","title":"Comparative effectiveness of sotrovimab and molnupiravir for preventing severe COVID-19 outcomes in patients on kidney replacement therapy: observational study using the OpenSAFELY-UKRR and SRR databases","abstract":"ABSTRACT Background Due to limited inclusion of patients on kidney replacement therapy (KRT) in clinical trials, the effectiveness of coronavirus disease 2019 (COVID-19) therapies in this population remains unclear. We sought to address this by comparing the effectiveness of sotrovimab against molnupiravir, two commonly used treatments for non-hospitalised KRT patients with COVID-19 in the UK. Methods With the approval of National Health Service England, we used routine clinical data from 24 million patients in England within the OpenSAFELY-TPP platform linked to the UK Renal Registry (UKRR) to identify patients on KRT. A Cox proportional hazards model was used to estimate hazard ratios (HRs) of sotrovimab versus molnupiravir with regards to COVID-19-related hospitalisations or deaths in the subsequent 28 days. We also conducted a complementary analysis using data from the Scottish Renal Registry (SRR). Results Among the 2367 kidney patients treated with sotrovimab (n = 1852) or molnupiravir (n = 515) between 16 December 2021 and 1 August 2022 in England, 38 cases (1.6%) of COVID-19-related hospitalisations/deaths were observed. Sotrovimab was associated with substantially lower outcome risk than molnupiravir {adjusted HR 0.35 [95% confidence interval (CI) 0.17–0.71]; P = .004}, with results remaining robust in multiple sensitivity analyses. In the SRR cohort, sotrovimab showed a trend toward lower outcome risk than molnupiravir [HR 0.39 (95% CI 0.13–1.21); P = .106]. In both datasets, sotrovimab had no evidence of an association with other hospitalisation/death compared with molnupiravir (HRs ranged from 0.73 to 1.29; P > .05). Conclusions In routine care of non-hospitalised patients with COVID-19 on KRT, sotrovimab was associated with a lower risk of severe COVID-19 outcomes compared with molnupiravir during Omicron waves.","journal":"Clinical Kidney Journal","year":2023,"id":361045,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9532,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1113222,"name":"Jacqueline Campbell","orcid":"0000-0002-8757-5872","position":1,"is_corresponding":false},{"id":655544,"name":"Edward J Carr","orcid":"0000-0001-9343-4593","position":2,"is_corresponding":false},{"id":1113223,"name":"John Tazare","orcid":"0000-0002-7194-2615","position":3,"is_corresponding":false},{"id":1113224,"name":"Linda Nab","orcid":"0000-0002-1821-7246","position":4,"is_corresponding":false},{"id":860268,"name":"Viyaasan Mahalingasivam","orcid":"0000-0002-3157-1127","position":5,"is_corresponding":false},{"id":19520,"name":"Amir Mehrkar","orcid":"0000-0002-2098-1278","position":6,"is_corresponding":false},{"id":707240,"name":"Shalini Santhakumaran","orcid":"0000-0003-0988-9339","position":7,"is_corresponding":false},{"id":1113225,"name":"Retha Steenkamp","orcid":"0000-0003-3448-5651","position":8,"is_corresponding":false},{"id":401926,"name":"Fiona Loud","orcid":"0000-0001-7706-5396","position":9,"is_corresponding":false},{"id":1113816,"name":"Susan Lyon","orcid":null,"position":10,"is_corresponding":false},{"id":1113226,"name":"Miranda Scanlon","orcid":"0000-0001-7398-3093","position":11,"is_corresponding":false},{"id":1113227,"name":"William Hulme","orcid":"0000-0002-9162-4999","position":12,"is_corresponding":false},{"id":1113228,"name":"Amelia Green","orcid":"0000-0002-7246-2074","position":13,"is_corresponding":false},{"id":19519,"name":"Helen J. Curtis","orcid":"0000-0003-3429-9576","position":14,"is_corresponding":false},{"id":1113229,"name":"Louis Fisher","orcid":"0000-0002-0295-3812","position":15,"is_corresponding":false},{"id":533649,"name":"Edward P K Parker","orcid":"0000-0001-5847-109X","position":16,"is_corresponding":false},{"id":19542,"name":"Ben Goldacre","orcid":"0000-0002-5127-4728","position":17,"is_corresponding":false},{"id":19543,"name":"Ian Douglas","orcid":"0000-0002-8970-1406","position":18,"is_corresponding":false},{"id":19545,"name":"Stephen Evans","orcid":"0000-0002-1474-2596","position":19,"is_corresponding":false},{"id":19525,"name":"Brian MacKenna","orcid":"0000-0002-3786-9063","position":20,"is_corresponding":false},{"id":108936,"name":"Samira Bell","orcid":"0000-0001-9100-1575","position":21,"is_corresponding":false},{"id":19526,"name":"Laurie A. Tomlinson","orcid":"0000-0001-8848-9493","position":22,"is_corresponding":false},{"id":453643,"name":"Dorothea Nitsch","orcid":"0000-0001-5767-248X","position":23,"is_corresponding":false},{"id":1113817,"name":"OpenSAFELY Collaborative and LH&W NCS (or CONVALESCENCE) Collaborative","orcid":null,"position":24,"is_corresponding":false},{"id":808943,"name":"Bang Zheng","orcid":"0000-0003-1814-6692","position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-19T01:14:10.680991Z","pmid":"37915915","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}