Subscribe to receive updates from the National Covid-19 Clinical Evidence Taskforce

[ACIPC Office]

Hi ACICP Members

If you havent already, you may like to subscribe to receive the weekly update from the National COVID-19 Clinical Evidence Taskforce, of which ACIPC is a member.

The latest update is below and you can subscribe to the weekly update here https://covid19evidence.net.au/#subscribe

Taskforce makes new recommendation on Lagevrio in partially vaccinated patients

No images? Click here
[http://i1.cmail20.com/ei/y/C8/10C/DDC/204409/csfinal/communique-header1-9900000000079e3c.png]

Edition 57 I 3 February 2022

WEEK IN REVIEW

New recommendation for Lagevrio in partially vaccinated patients

Further to the recent Taskforce published recommendation (31/1/22) for molnupiravir (Lagevrio) in at-risk unvaccinated patients with mild COVID-19, the Taskforce has today made a further consensus recommendation for its use in partially vaccinated patients.

Consensus recommendation:
In addition to at-risk unvaccinated adults, also consider using molnupiravir within 5 days of symptom onset in adults with COVID-19 who do not require oxygen and:
are immunosuppressed or not immunocompetent regardless of vaccination status; or
have received one or two doses of vaccine and who are at high risk of severe disease on the basis of age and multiple risk factors

AND where other treatments (such as sotrovimab or nirmatrelvir plus ritonavir) are not suitable or available.

Available research does not currently provide enough evidence to determine the benefits of molnupiravir in specific subgroups of patients. In the absence of definitive evidence, the Taskforce has arrived at a consensus recommendation based on their combined clinical expertise to guide clinical decisions about which patients are most likely to benefit from molnupiravir.

There is no evidence evaluating the effectiveness of molnupiravir in partially or fully vaccinated patients. Given this, and the lower risk of deterioration in these patients, it is unlikely that molnupiravir will have a significant treatment benefit in patients who have received three doses of vaccine, unless the patient is immunosuppressed.

There is limited evidence on the effectiveness of molnupiravir in immunosuppressed patients. However, given the likely higher risk of deterioration in these patients, and the absence of reasons to believe otherwise, it is likely that molnupiravir will be beneficial for immunosuppressed patients.

The remark accompanying the recommendation defines immunocompromising conditions.

Molnupiravir is now being considered by our special population panels to determine whether additional specific recommendations are needed for these groups.

Welcome to ACNN

This week the Taskforce welcomed its 33rd member organisation, the Australian College of Neonatal Nurses (ACNN).
We look forward to their insights and expertise adding value to our guidance for those caring for neonates during the pandemic.

[http://i3.cmail20.com/ei/y/C8/10C/DDC/204409/csfinal/ACNNFinalLogo_2014hires-9905140b6d01453c.jpg]

Help shape the guidelines

The Taskforce wants to identify the uses, impacts, strengths and opportunities for improvement in the ongoing work of the Taskforce and our guidelines. We are inviting Australian healthcare practitioners to participate in a brief survey.

Please share the survey with your clinical colleagues. A summary of the results, including no identifying information, will be used to enhance the impact and dissemination of the guidelines and flowcharts.

The survey closes on Monday, 7 February.
[Taskforce survey]
[Twitter][LinkedIn]

QUICK STATISTICS

COVID-19 research pipeline
[Research pipeline]

LIVING GUIDELINES
NEW RECOMMENDATIONS

Molnupiravir (Lagevrio)
Consensus recommendation
In addition to at-risk unvaccinated adults, also consider using molnupiravir within 5 days of symptom onset in adults with COVID-19 who do not require oxygen and:
are immunosuppressed or not immunocompetent regardless of vaccination status; or
have received one or two doses of vaccine and who are at high risk of severe disease on the basis of age and multiple risk factors

AND where other treatments (such as sotrovimab or nirmatrelvir plus ritonavir) are not suitable or available.

UPDATED RECOMMENDATIONS

Sotrovimab
The text in the conditional and consensus recommendations have been updated for consistency with the new Paxlovid and Lagevrio recommendations. There is no new evidence or change in the strength or direction of the recommendations.

The Taskforce is continually monitoring research to update recommendations as new evidence emerges.

[Australian guidelines for the clinical care of people with COVID-19: Version 50.1]

CLINICAL FLOWCHARTS
13 clinical flowcharts have been developed by the Taskforce to cover:
Disease-modifying treatments for adults with COVID-19 UPDATED
Pathways to Care for adults with COVID-19
Pathways to Care for children and adolescents with COVID-19
Management of adults with mild COVID-19
Management of adults with moderate to severe COVID-19
Management of adults with severe to critical COVID-19
Respiratory support for adults with severe to critical COVID-19
Management of people with COVID-19 who are older and living with frailty and/or cognitive impairment
Management of people with COVID-19 who are receiving palliative care
Care of people with Post-acute COVID-19
Preparedness for CPR during the COVID-19 pandemic
CPR for adults with COVID-19 in healthcare settings
Basic life support for adults in the community during the pandemic

Changes to flowcharts reflect:
New recommendation for molnupiravir (Lagevrio)
[Disease-modifying treatment flowchart]

TOPICS UNDER REVIEW

We are currently reviewing evidence to develop recommendations and flowcharts to guide practice in areas including:
Tixagevimab and cilgavimab (Evusheld)
Molnupiravir (Lagevrio) for use in special populations
Nirmatrelvir plus ritonavir (Paxlovid) for use in special populations
Fluvoxamine
Metformin NEW
Regdanvimab
Remdesivir
Casirivimab plus imdevimab (Ronapreve)
Dexamethasone
Care of people with Post-COVID-19

NEWS & EVENTS
Cochrane

This week Cochrane published a new systematic review: Interleukin1 blocking agents for treating COVID19. Consistent with the Taskforce recommendations for anakinra and canakinumab, the authors found no evidence for an important beneficial effect of IL1 blocking agents.

NEW TOPICS & QUESTIONS

It is a core mission of the Taskforce to engage with frontline clinicians to rapidly identify and address priority clinical questions.

Each week we collect suggestions for new clinical questions or topics for consideration by the Taskforce. View all the suggested questions, topics and new patient groups that have been received to date here.

Please encourage your clinical colleagues to provide their insights via the website

QUICK LINKS

[http://i4.cmail20.com/ei/y/C8/10C/DDC/204409/csfinal/quick-links-living-guidelines-990000079e028a3c.png]

[http://i5.cmail20.com/ei/y/C8/10C/DDC/204409/csfinal/quick-links-clinical-flowcharts-990000079e028a3c.png]
[http://i6.cmail20.com/ei/y/C8/10C/DDC/204409/csfinal/quick-links-evidence-under-review-990000079e028a3c.png]

[http://i7.cmail20.com/ei/y/C8/10C/DDC/204409/csfinal/quick-links-questions-990000079e028a3c.png]

You are receiving this email because you signed up for Taskforce updates via our website. Update your preferences or unsubscribe from this list.

2022 National COVID-19 Clinical Evidence Taskforce. All rights reserved.

[http://i8.cmail20.com/ei/y/C8/10C/DDC/204409/csfinal/rev-national-covid-19-clinical-logo1-990a28000001453c.png]

Unsubscribe

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

To send a message to the list administrator send an email to admin@acipc.org.au

You can unsubscribe manually from this list by sending ‘signoff acipclist’

[Author]

Posts