{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:01:39Z","timestamp":1777453299060,"version":"3.51.4"},"reference-count":8,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Antiviral Therapy"],"published-print":{"date-parts":[[2025,2]]},"abstract":"\n Background<\/jats:title>\n 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\u2019s standard 5-day course. This study aims to identify and evaluate a nirmatrelvir dosage regimen that lowers symptom rebound.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among the 58 prescribed case patients, 49 filled and initiated the prescription. Of those 49 patients, four took the medication for fewer than 5\u00a0days, 24 for 5\u00a0days (standard regimen), and 21 for 7 or 8\u00a0days (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.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These findings suggest that a longer nirmatrelvir\/ritonavir course might reduce rebound symptoms compared to the standard 5-day regimen.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/13596535251323728","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T19:42:31Z","timestamp":1739821351000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nirmatrelvir treatment duration and frequency of COVID-19 rebound"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1933-7996","authenticated-orcid":false,"given":"Nathan","family":"Sudeep","sequence":"first","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey D","family":"Klausner","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"bibr1-13596535251323728","unstructured":"Ritonavir-Boosted Nirmatrelvir (Paxlovid). COVID-19 treatment guidelines. https:\/\/www.covid19treatmentguidelines.nih.gov\/therapies\/antivirals-including-antibody-products\/ritonavir-boosted-nirmatrelvir-paxlovid-\/"},{"key":"bibr2-13596535251323728","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2118542"},{"key":"bibr3-13596535251323728","author":"Jewett C","journal-title":"N Y Times"},{"key":"bibr4-13596535251323728","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7251a1"},{"key":"bibr5-13596535251323728","doi-asserted-by":"publisher","DOI":"10.1002\/psp4.13039"},{"key":"bibr6-13596535251323728","volume-title":"Emergency Use Authorization for Paxlovid","author":"Center for Drug Evaluation and Research Review","year":"2021"},{"key":"bibr7-13596535251323728","doi-asserted-by":"publisher","DOI":"10.1101\/2022.06.21.22276724"},{"key":"bibr8-13596535251323728","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac443"}],"container-title":["Antiviral Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13596535251323728","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13596535251323728","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13596535251323728","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:53:23Z","timestamp":1777380803000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13596535251323728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1177\/13596535251323728"],"URL":"https:\/\/doi.org\/10.1177\/13596535251323728","relation":{},"ISSN":["1359-6535","2040-2058"],"issn-type":[{"value":"1359-6535","type":"print"},{"value":"2040-2058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"article-number":"13596535251323728"}}