Evidence map›Paper›PMID 39960062›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025

Ensitrelvir for the Treatment of Nonhospitalized Adults with COVID-19: Results from the SCORPIO-HR, Phase 3, Randomized, Double-blind, Placebo-Controlled Trial.

Anne F Luetkemeyer, Kara W Chew, Stuart Lacey, Michael D Hughes, Linda J Harrison, Eric S Daar, Joseph Eron, Courtney V Fletcher, Alexander L Greninger, Diane Hessinger and 12 more

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05305547 (A Phase 3, Multicenter, Randomized, Double-Blind, 24-Week Study of the Clinical and Antiviral Effect of S-217622 Compared With Placebo in Non-Hospitalized Participants With COVID-19), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05305547 phase3completednot on this map

A Phase 3, Multicenter, Randomized, Double-Blind, 24-Week Study of the Clinical and Antiviral Effect of S-217622 Compared With Placebo in Non-Hospitalized Participants With COVID-19

TypeinterventionalSponsorShionogiRan2022 to 2024Enrolled2,093ConditionsSARS-CoV-2 InfectionArmsS-217622, Placebo
3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Antiviral Trials-Navigating the Shifting Sands of a Pandemic.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Anne F LuetkemeyerDivision of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0003-0911-1578
Kara W ChewDivision of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA.ORCID 0000-0003-4865-4348
Stuart LaceyBiostatistics, Shionogi B.V., London, United Kingdom.
Michael D HughesCenter for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Linda J HarrisonCenter for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.ORCID 0000-0002-3170-0865
Eric S DaarDivision of HIV Medicine, Lundquist Institute at Harbor University of California Los Angeles, Torrance, California, USA.ORCID 0000-0003-1880-7331
Joseph EronDivision of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Courtney V FletcherUNMC Center for Drug Discovery, University of Nebraska Medical Center, Omaha, Nebraska, USA.ORCID 0000-0002-3703-7849
Alexander L GreningerDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-7443-0527
Diane HessingerNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Jonathan Z LiBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0001-9914-9662
David MailhotNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
David WohlDivision of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID 0000-0002-7764-0212
Methee ChayakulkeereeDivision of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.ORCID 0000-0002-4582-4914
Jose Luis Accini MendozaInternal Medicine Department, IPS Centro Cientifico Asistencial S.A.S., Barranquilla, Colombia.
Polina ElistratovaClinical Development, Shionogi Inc., Florham Park, New Jersey, USA.
Oluwaseun MakindeClinical Development, Shionogi Inc., Florham Park, New Jersey, USA.
Gareth MorganPortfolio Management, Shionogi Inc., Florham Park, New Jersey, USA.
Simon PortsmouthClinical Development, Shionogi Inc., Florham Park, New Jersey, USA.ORCID 0000-0002-9853-4160
Takeki UeharaDrug Development and Regulatory Science Division, Shionogi & Co., Ltd., Osaka, Japan.ORCID 0000-0002-5853-9426
Davey SmithAntiviral Research Center, University of California, San Diego, California, USA.ORCID 0000-0003-3603-1733
Judith S CurrierDivision of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA.ORCID 0000-0003-4279-4737

Funding

Leadership and Operations Center (LOC), AIDS Clinical Trials Group (ACTG); LOC 1/UM1AI068636 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Joseph J Eron, RAJESH T GANDHI · 2011 to 2026
$1073.1M
Statistical and Data Management Center (SDMC), AIDS Clinical Trials Group (ACTG)UM1AI068634 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Marlene Ann Cooper, Michael David Hughes · 2011 to 2026
$246.6M
Validation, CLIA and Qualification (VQC): Enhancing the RS ratio as a tool for AIDS Clinical Trial Group (ACTG) tuberculosis trialsUM1AI106701 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Grace M Aldrovandi · 2014 to 2026
$116.8M
Harvard Medical School Vaccine Clinical Trials UnitUM1AI069412 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI Lindsey Robert Baden, Daniel R. Kuritzkes · 2012 to 2026
$57.2M
UCLA AIDS Prevention and Treatment Clinical Trials UnitUM1AI069424 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Judith S. Currier, RAPHAEL J LANDOVITZ · 2012 to 2026
$51.8M
San Francisco Vaccine and Prevention UnitUM1AI069496 · NIAID · PUBLIC HEALTH FOUNDATION ENTERPRISES · PI Susan Buchbinder, Diane V Havlir · 2012 to 2026
$30.5M
National Institute of Allergy and Infectious Diseases of the National Institutes of Health UM1AI068634National Institute of Allergy and Infectious Diseases of the National Institutes of Health UM1AI068636National Institute of Allergy and Infectious Diseases of the National Institutes of Health UM1AI106701NIAID NIH HHS UM1 AI068634NIAID NIH HHS UM1 AI068636NIAID NIH HHS UM1 AI069412NIAID NIH HHS UM1 AI069424NIAID NIH HHS UM1 AI069496NIAID NIH HHS UM1 AI106701Shionogi & Co., Ltd.
6 · The paper itself

Abstract

backgroundEnsitrelvir, a severe acute respiratory syndrome coronavirus-2 main protease inhibitor, has demonstrated clinical and virologic efficacy in previous studies.

methodsIn this global phase 3 trial, nonhospitalized adults with mild-to-moderate coronavirus disease 2019 (COVID-19) and symptom onset within 5 days were randomized (1:1) to receive once-daily ensitrelvir (375 mg day 1, 125 mg days 2-5) or blinded matching placebo. The primary endpoint was the restricted mean time to sustained (≥2 days) resolution of 15 COVID-19 symptoms, recorded in participant daily diaries, through day 29 in participants starting treatment within 3 days after symptom onset. Virologic efficacy and safety were assessed.

resultsOf 2093 participants, 1888 started treatment within 3 days after symptom onset. Mean time to symptom resolution was 12.5 and 13.1 days with ensitrelvir and placebo, respectively (difference, -0.6 days; 95% confidence interval, -1.38 to 0.19; P = .14). On day 4, ensitrelvir reduced least-squares mean RNA by 0.72 log10 copies/mL more than placebo (95% confidence interval, 0.55-0.90). Among those with positive viral cultures at enrollment, 274/287 (95.5%) ensitrelvir-treated versus 210/280 (75.0%) placebo-treated participants had negative cultures on day 4. RNA rebound was similar (<1.5%) between groups. The proportion of participants with ≥1 adverse event was similar with ensitrelvir (61.5%) and placebo (60.6%). No treatment-related serious adverse events or deaths occurred. Three (0.3%) ensitrelvir-treated and 1 (0.1%) placebo-treated participants had COVID-19-related hospitalizations by day 29.

conclusionsDespite the evidence of antiviral activity with ensitrelvir, this trial did not demonstrate a significant difference in time to sustained symptom resolution. CLINICAL TRIALS REGISTRATION NUMBER: NCT05305547.

Indexed as

Antiviral AgentsCOVID-19 Drug TreatmentAdultAgedCOVID-19Double-Blind MethodFemaleHumansIndazolesMaleMiddle AgedSARS-CoV-2Treatment OutcomeTriazinesTriazolesYoung AdultAntiviral AgentsensitrelvirIndazolesTriazinesTriazolesCOVID-19ensitrelvirhigh risksymptom resolutionviral rebound

Identifiers

PMID39960062
PMCPMC12272848

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.