Nirmatrelvir treatment duration and frequency of COVID-19 rebound.

IF 2.3 4区医学 Q4 INFECTIOUS DISEASES Antiviral Therapy Pub Date : 2025-02-01 DOI:10.1177/13596535251323728

Nathan Sudeep, Noah Kojima, Jeffrey D Klausner

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Abstract

Background: Nirmatrelvir has been shown to reduce morbidity and mortality associated with COVID-19. However, it is underutilized due to concerns regarding COVID-19 symptom rebound following nirmatrelvir's standard 5-day course. This study aims to identify and evaluate a nirmatrelvir dosage regimen that lowers symptom rebound.

Methods: Based on nirmatrelvir pharmacokinetics, we propose a novel 8-day regimen: two doses twice-daily followed by six doses once-daily to reduce rebound frequency. We then carried out a retrospective case series study of clinical outcomes among our patients to investigate their frequency of COVID-19 symptom rebound following nirmatrelvir usage.

Results: Among the 58 prescribed case patients, 49 filled and initiated the prescription. Of those 49 patients, four took the medication for fewer than 5 days, 24 for 5 days (standard regimen), and 21 for 7 or 8 days (extended regimen). Among 5-day treatment cases (n = 24), 8 (33%) experienced clinical rebound, whereas among the 7-day or 8-day treatment cases (n = 21), 2 (9.5%) experienced rebound.

Conclusions: These findings suggest that a longer nirmatrelvir/ritonavir course might reduce rebound symptoms compared to the standard 5-day regimen.

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尼马特瑞韦治疗时间和COVID-19反弹频率。

背景：Nirmatrelvir已被证明可降低与COVID-19相关的发病率和死亡率。然而，由于担心在尼马特韦的标准5天疗程后COVID-19症状反弹，它没有得到充分利用。本研究旨在确定和评估一种能降低症状反弹的尼马特利韦给药方案。方法：基于尼马特利韦的药代动力学，我们提出了一种新的8天治疗方案：每天2次给药，然后每天1次给药6次，以减少反弹频率。然后，我们对患者的临床结果进行了回顾性病例系列研究，以调查他们在使用尼马特瑞韦后COVID-19症状反弹的频率。结果：58例开药患者中，49例开药。在这49名患者中，4名患者服药时间少于5天，24名患者服药5天（标准方案），21名患者服药7天或8天（延长方案）。在治疗5天的病例中，有8例（33%）出现临床反弹，而在治疗7天或8天的病例中，有2例（9.5%）出现临床反弹。结论：这些发现表明，与标准的5天治疗方案相比，较长的尼马特利韦/利托那韦疗程可能会减少反弹症状。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antiviral Therapy 医学-病毒学

CiteScore

2.60

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.