tetano
Editor, Senior Moderator
Antivir Ther
. 2025 Feb;30(1):13596535251323728.
doi: 10.1177/13596535251323728. Nirmatrelvir treatment duration and frequency of COVID-19 rebound
Nathan Sudeep[SUP] 1 [/SUP], Noah Kojima[SUP] 1 [/SUP], Jeffrey D Klausner[SUP] 1 [/SUP]
Affiliations
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.
Keywords: COVID-19; Paxlovid; nirmatrelvir; rebound.
. 2025 Feb;30(1):13596535251323728.
doi: 10.1177/13596535251323728. Nirmatrelvir treatment duration and frequency of COVID-19 rebound
Nathan Sudeep[SUP] 1 [/SUP], Noah Kojima[SUP] 1 [/SUP], Jeffrey D Klausner[SUP] 1 [/SUP]
Affiliations
- PMID: 39961599
- DOI: 10.1177/13596535251323728
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.
Keywords: COVID-19; Paxlovid; nirmatrelvir; rebound.