“In an updated analysis of 1153 patients enrolled through December 2021, treatment with Paxlovid showed a nonsignificant 51% relative risk reduction in hospitalization or death. Among 721 vaccinated adults with at least 1 risk factor, treatment with Paxlovid showed a nonsignificant 57% relative risk reduction.”
"Nonsignificant" is the key word in that quote. Both times. (and in fact several other times in the linked article).
So, it's not a strong enough or consistent enough difference between treatment and placebo to be certain that it isn't just chance. (this could happen if for example if out of our 1000 data points, 2 people on placebo were hospitalised but only 1 on the treatment was hospitalised. That'd be "a 50% reduction in risk", but not be statistically significant since it could easily have just been random chance when we're talking about such a small difference).
Probably needs an even larger sample population to really nail down whether it's real or not. Seems suggestive that all the various reported tests showed (inconclusive) benefits when you'd expect an actually-ineffective treatment to show results varying randomly in both "effective" and "not-effective" directions, though that could certainly be positive reporting bias, especially since it's being run and reported by a company with a financial stake in the results.
There's not enough data to say whether or not the efficacy has dropped off. EPIC-SR is a different patient population, and Pfizer hasn't released data for the primary endpoint in EPIC-SR of symptom relief. For the secondary endpoint of hospitalization or death, they got about a 50% reduction, but it's not significant, because the numbers were 5 hospitalizations or deaths in the treatment group and 10 in the placebo group.
Ummm…the first interim analysis of 853 patients failed to show a difference.
Then the secondary analysis of another 1163 patients failed to show a difference AND the delta between the two arms was smaller than the first analysis.
Its trending towards no difference between arms.
And symptom relief has a huge subjective aspect to it since it based on a patient questionnaire.
If it shows no difference in hospitalization or death but some small effect on symptoms it has little value as a treatment. It going to end up like Tamiflu.
And i just checked clinicaltrials.gov, Pfizer terminated the trial.
Look, I'm sure you took a stats course so you know all of this, but it's not the number of patients that matters, it's the number of events in the endpoint. They got 5 on treatment and 10 on control. If they wanted p<.05 they would need to substantially enlarge the study. The good news is that among vaccinated, "standard risk" people, it's fairly rare to go to the hospital even without Paxlovid.
This study just isn't powered well enough to say for sure whether Paxlovid provides a hospitalization/death benefit or not for the standard risk group. It also doesn't really provide any good information about whether newer variants cause Paxlovid to work better or worse.
https://www.empr.com/home/news/drugs-in-the-pipeline/mixed-r...