Traws Pharma's ratutrelvir tracks Paxlovid in small COVID trial, shaping a niche bid

Traws Pharma has put a first marker down for ratutrelvir's commercial case. On 12 November 2026 the company reported final Phase 2a results for the oral antiviral, which it is positioning for people who cannot take Paxlovid. In mild-to-moderate COVID-19, patients on ratutrelvir recovered in a median of 13.5 days, against 14.5 days on Paxlovid. The company reported no rebound of the virus through Day 28.

The safety numbers lean in ratutrelvir's favour but rest on very few events. One of 32 patients on ratutrelvir had a treatment-related adverse event, against four of 30 on Paxlovid. The material available does not say what those events were. It also does not explain how the 32- and 30-patient arms relate to the 92 people enrolled, so the remaining participants cannot be accounted for here.

Traws said it plans to discuss a possible registration path with the US Food and Drug Administration for patients who are ineligible for Paxlovid. It gave no date for those talks and has not disclosed what endpoints or populations might be acceptable. No information was provided on market size, pricing, partnering or funding, so the commercial value of that route cannot yet be assessed.

The company also said it has completed a tablet bridging study and a toxicology retest for tivoxavir marboxil, its influenza prophylaxis candidate. It plans a regulatory resubmission in the fourth quarter of 2026. That would give Traws two regulatory storylines to run in parallel.