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Phase 3 Completed N=1,735 Randomized Double-blind Treatment

Efficacy and Safety of Molnupiravir (MK-4482) in Non-Hospitalized Adult Participants With COVID-19 (MK-4482-002)

Coronavirus Disease (COVID-19)
Source: ClinicalTrials.gov NCT04575597 ↗
Enrolled (actual)
1,735
Serious AEs
7.7%
Results posted
Jun 2023
Primary outcomePrimary: Percentage of Participants Who Were Hospitalized and/or Died Through Day 29 (Primary Pre-specified Analysis) — 1.4; 3.9; 4.1; 5.4 Percentage of Participants — p=0.0012
◆ Published Evidence
Established
99citations · ~25 / year
Phase 2/3 Trial of Molnupiravir for Treatment of Covid-19 in Nonhospitalized Adults.
NEJM evidence · 2022 · High-confidence link

Summary

This study aims to evaluate the safety, tolerability and efficacy of molnupiravir (MK-4482) compared to placebo. The primary hypothesis is that molnupiravir is superior to placebo as assessed by the percentage of participants who are hospitalized and/or die through Day 29

Linked Publications (5)

  • Phase 2/3 Trial of Molnupiravir for Treatment of Covid-19 in Nonhospitalized Adults.
    NEJM evidence · 2022 · 99 citations · High-confidence link
  • Impact of Molnupiravir Treatment on Patient-Reported COVID-19 Symptoms in the Phase 3 MOVe-OUT Trial: A Randomized, Placebo-Controlled Trial.
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023 · 20 citations · Open access · Likely link
  • Virologic Outcomes with Molnupiravir in Non-hospitalized Adult Patients with COVID-19 from the Randomized, Placebo-Controlled MOVe-OUT Trial.
    Infectious diseases and therapy · 2023 · 11 citations · Open access · Likely link
  • Impact of differences between interim and post-interim analysis populations on outcomes of a group sequential trial: Example of the MOVe-OUT study.
    Clinical trials (London, England) · 2025 · 1 citation · Open access · Likely link
  • Impact of baseline humoral immunity on treatment outcomes with molnupiravir in the MOVe-OUT randomized, controlled trial.
    Virology · 2026 · 0 citations · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants Who Were Hospitalized and/or Died Through Day 29 (Primary Pre-specified Analysis)
1.4; 3.9; 4.1; 5.4; 7.3; 14.1 0.0012 sig
PRIMARY
Number of Participants With an Adverse Event (AE)
29; 24; 29; 28; 230; 239
PRIMARY
Number of Participants Who Discontinued Study Intervention Due to an AE
0; 0; 3; 1; 10; 20
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Cough
7.0; 6.5; 8.0; 6.0; 10.0; 10.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Sore Throat
3.0; 3.0; 4.5; 5.0; 4.0; 5.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Nasal Congestion
4.0; 4.0; 8.0; 5.0; 5.0; 6.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Rhinorrhea
4.0; 8.0; 9.0; 5.0; 5.0; 5.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Shortness of Breath or Difficulty Breathing
7.0; 4.0; 9.0; 5.0; 6.0; 9.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Muscles or Body Aches
5.0; 4.0; 4.5; 4.0; 4.0; 5.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Fatigue
7.0; 5.0; 6.0; 6.0; 6.0; 7.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Feeling Hot or Feverish
4.0; 2.0; 4.0; 3.5; 3.0; 4.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Chills
2.0; 2.0; 3.0; 4.0; 3.0; NA
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Headache
4.0; 4.0; 4.0; 6.0; 5.0; 5.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Nausea
5.0; 3.0; 6.0; 5.0; 4.0; 4.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Vomiting
4.0; 8.0; 5.0; 2.0; 3.0; NA
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Diarrhea
6.0; 4.0; 3.0; 2.0; 3.0; 3.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Loss of Taste
6.0; 6.0; 10.0; 9.0; 9.0; 10.0
SECONDARY
Time to Sustained Resolution or Improvement of Each Targeted COVID-19 Sign/Symptom - Loss of Smell
7.0; 10.0; 12.0; 12.0; 10.0; 11.0
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Cough
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Sore Throat
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Nasal Congestion
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Rhinorrhea
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Shortness of Breath or Difficulty Breathing
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Muscle or Body Aches
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Fatigue
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Feeling Hot or Feverish
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Chills
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Headache
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Nausea
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Vomiting
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Diarrhea
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Loss of Taste
NA; NA; NA; NA; NA; NA
SECONDARY
Time to Progression of Each Targeted COVID-19 Sign/Symptom - Loss of Smell
NA; NA; NA; NA; NA; NA
SECONDARY
Number of Participants With Responses on WHO 11-point Ordinal Outcomes Score on a Scale on Day 3
2; 0; 0; 1; 2; 3
SECONDARY
Number of Participants With Responses on WHO 11-point Ordinal Outcomes Score on a Scale on End of Treatment (EOT [Day 5])
3; 0; 2; 1; 11; 10
SECONDARY
Number of Participants With Responses on WHO 11-point Ordinal Outcomes Score on a Scale on Day 10
9; 11; 3; 4; 40; 32
SECONDARY
Number of Participants With Responses on WHO 11-point Ordinal Outcomes Score on a Scale on Day 15
20; 21; 13; 11; 102; 94
SECONDARY
Number of Participants With Responses on WHO 11-point Ordinal Outcomes Score on a Scale on Day 29
35; 40; 39; 36; 312; 314

Eligibility Criteria

Inclusion Criteria

  • Has documentation of laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with sample collection ≤5 days prior to the day of randomization. PCR is the preferred method; however with evolving approaches to laboratory confirmation of SARS-CoV-2 infection, other molecular or antigen tests that detect viral ribonucleic acid (RNA) or protein are allowed if authorized for use in the country. Serological tests that detect host antibodies generated in response to recent or prior infection are not allowed.
  • Had initial onset of signs/symptoms attributable to COVID-19 for ≤5 days prior to the day of randomization and at least 1 of the following sign/symptom attributable to COVID-19 on the day of randomization.
  • Has mild or moderate COVID-19.
  • Has at least 1 characteristic or underlying medical condition associated with an increased risk of severe illness from COVID-19.
  • Males agree to the following during the intervention period and for at least 4 days after the last dose of study intervention: Either abstain from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent; or must agree to use contraception.
  • Females are not pregnant or breastfeeding, and at least one of the following conditions applies: Is not a woman of child bearing potential (WOCBP); or is a WOCBP and using a contraceptive method that is highly effective (a low user dependency method OR a user dependent method in combination with barrier method), or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) for at least 4 days after the last dose of study intervention; a WOCBP must have a negative highly sensitive pregnancy test (urine or serum test is required) within 24 hours before the first dose of study intervention.

Exclusion Criteria

  • Is currently hospitalized or is expected to need hospitalization for COVID-19 within 48 hours of randomization.
  • Is on dialysis or has reduced estimated glomerular filtration rate (eGFR) 50 copies/mL (regardless of CD4 count) or an AIDS-defining illness in the past 6 months, participants with HIV may only be enrolled if on a stable antiretroviral therapy regimen; a neutrophilic granulocyte absolute count 3X upper limit of normal at screening.
  • Has a platelet count <100, 000/μL or received a platelet transfusion in the 5 days prior to randomization.
  • Is taking or is anticipated to require any prohibited therapies.
  • Is unwilling to abstain from participating in another interventional clinical study through Day 29 with an investigational compound or device, including those for COVID-19 therapeutics.
  • Has hypersensitivity or other contraindication to any of the components of the study interventions as determined by the investigator.
  • Has any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant or that could prevent, limit, or confound the protocol-specified assessments including but not limited to: participants who are not expected to survive longer than 48 hours after randomization, or participants with a recent history of mechanical ventilation, or participants with conditions that could limit gastrointestinal absorption of capsule contents.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04575597) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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