What You Should Know
Molnupiravir, an oral antiviral used for COVID-19 treatment, has been found to induce mutations in the virus genome during replication.
The study, published in Nature, identified a specific class of mutations characterized by a high proportion of G-to-A and C-to-T mutations that appeared predominantly in sequences from 2022, after the introduction of molnupiravir treatment.
Merck, the pharmaceutical company that produces molnupiravir, disputed the study's findings, stating that the mutations were uncommon and associated with sporadic cases.
A new study reports that Molnupiravir (Lagevrio) can cause mutations, which could potentially spread to others. The investigators said they found some patients treated with the oral antiviral did not clear the virus, which could lead to new mutations that can be transmitted to other people.
The findings were published in Nature.
“Using a systematic approach, we find that a specific class of long phylogenetic branches, distinguished by a high proportion of G-to-A and C-to-T mutations, appear almost exclusively in sequences from 2022, after the introduction of molnupiravir treatment, and in countries and age-groups with widespread usage of the drug,” the investigators wrote. “We identify a mutational spectrum, with preferred nucleotide contexts, from viruses in patients known to have been treated with molnupiravir and show that its signature matches that seen in these long branches, in some cases with onwards transmission of molnupiravir-derived lineages.”
Molnupiravir induces mutations in the virus genome during replication.
The study looked at both patients who were treated with the oral antiviral and those who were not. According to a report in FirstWord Pharma, Merck disputed the study. “According to a spokesperson for the company, the authors instead "rely on circumstantial associations between the region from which the sequence was identified and timeframe of sequence collection in countries where molnupiravir is available to draw their conclusion." The spokesperson added that genomes with the mutations were "uncommon and were associated with sporadic cases."
Back in November 2021, molnupiravir became the first oral antiviral pill to be authorized for COVID-19 treatment. The authorization of molnupiravir was based on findings from the phase 3 MOVe-OUT trial, which was randomized, placebo-controlled, double-blind trial assessing the 800 mg twice-daily pill in unvaccinated adults with ≥1 risk factor associated with worse COVID-19 outcomes, who had symptom onset within 5 days prior to their trial randomization but were not hospitalized for their disease.