Olumiant (baricitinib) vs Paxlovid (nirmatrelvir and ritonavir)

Olumiant (baricitinib) vs Paxlovid (nirmatrelvir and ritonavir)

Olumiant (baricitinib) is an oral Janus kinase (JAK) inhibitor, primarily used to treat moderate to severe rheumatoid arthritis, and has also received emergency use authorization for treating certain hospitalized COVID-19 patients. In contrast, Paxlovid is an antiviral treatment specifically designed to combat COVID-19, consisting of nirmatrelvir, which inhibits viral replication, and ritonavir, which slows down nirmatrelvir's breakdown to enhance its effectiveness. When deciding between the two, it is important to consider the indication: Olumiant is for individuals with specific inflammatory conditions and certain COVID-19 cases, while Paxlovid is targeted toward early treatment of COVID-19 to prevent severe illness, particularly in those at high risk for progression to severe disease.

Difference between Olumiant and Paxlovid

Metric Olumiant (baricitinib) Paxlovid (nirmatrelvir and ritonavir)
Generic name Baricitinib Nirmatrelvir and Ritonavir
Indications Rheumatoid arthritis, COVID-19 (under Emergency Use Authorization) Treatment of COVID-19 in patients at high risk for progression to severe illness
Mechanism of action Janus kinase (JAK) inhibitor, interfering with the JAK-STAT signaling pathway Nirmatrelvir inhibits SARS-CoV-2 protease, preventing viral replication; Ritonavir slows down nirmatrelvir's breakdown to prolong its effect
Brand names Olumiant Paxlovid
Administrative route Oral Oral
Side effects Upper respiratory tract infections, nausea, headache, hypertension Dysgeusia, diarrhea, hypertension, myalgia
Contraindications Active serious infections, hypersensitivity to baricitinib Concomitant use with strong CYP3A4 inducers, hypersensitivity to any component of the product
Drug class JAK inhibitor Protease inhibitor (nirmatrelvir), CYP3A inhibitor (ritonavir)
Manufacturer Eli Lilly and Company Pfizer Inc.

Efficacy

Efficacy of Olumiant (Baricitinib) in Treating COVID-19

Olumiant (baricitinib) is an oral medication that was originally approved for the treatment of moderate to severe rheumatoid arthritis. However, it has been repurposed and authorized for emergency use by the U.S. Food and Drug Administration (FDA) for the treatment of COVID-19 in certain hospitalized adults. Baricitinib is a Janus kinase (JAK) inhibitor that is thought to modulate the immune response that can cause the severe complications associated with COVID-19. Clinical trials have demonstrated that baricitinib, particularly when used in combination with remdesivir, can reduce recovery time and improve clinical outcomes in hospitalized patients with COVID-19, especially those requiring supplemental oxygen or mechanical ventilation.

The efficacy of baricitinib in treating COVID-19 has been evaluated in several studies. One of the key trials, known as the Adaptive COVID-19 Treatment Trial (ACTT-2), showed that hospitalized patients with COVID-19 who received baricitinib plus remdesivir had a median recovery time one day shorter than those who received remdesivir alone. Furthermore, the combination therapy was associated with a lower likelihood of disease progression, notably in patients requiring high-flow oxygen or non-invasive ventilation. These findings suggest that baricitinib can play a significant role in mitigating the impact of COVID-19 when added to standard antiviral treatment.

Efficacy of Paxlovid (Nirmatrelvir and Ritonavir) in Treating COVID-19

Paxlovid is an antiviral medication that combines nirmatrelvir, which inhibits a protein the SARS-CoV-2 virus requires to replicate, with ritonavir, a drug that helps slow the breakdown of nirmatrelvir, thereby enhancing its effectiveness. The FDA has granted Emergency Use Authorization (EUA) for Paxlovid for the treatment of mild to moderate COVID-19 in individuals aged 12 and older who are at high risk for progression to severe disease. Clinical trial data have shown that Paxlovid significantly reduces the risk of hospitalization or death in patients with COVID-19 when treatment is initiated within five days of symptom onset.

In a pivotal clinical trial, Paxlovid reduced the risk of COVID-19-related hospitalization or death by 89% compared to placebo when treatment was started within three days of symptom onset in non-hospitalized high-risk adults. When treatment was initiated within five days, the risk reduction was 88%. These results underscore the importance of early treatment with Paxlovid for eligible patients. The high efficacy of Paxlovid in preventing severe outcomes has made it a critical tool in the management of COVID-19, particularly for those at increased risk of complications due to age, underlying health conditions, or other factors.

Regulatory Agency Approvals

Olumiant
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Therapeutic Goods Administration (TGA), Australia
Paxlovid
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Health Canada
  • Therapeutic Goods Administration (TGA), Australia
  • Medicines & Healthcare products Regulatory Agency (MHRA), United Kingdom

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