BibTex format
@article{Wawman:2026:10.1183/23120541.01560-2025,
author = {Wawman, RE and Shah, PL and Boffito, M and Tonkin, J and Conway, F and Tana, A and Santos, BR and Grinsztejn, B and Ram铆rez, BC and Pertinez, H and Owen, A and Curley, P and Arshad, U and Cox, H and Johnson, MR and Pozniak, A and Pelly, M and Orton, CM and Bhavsar, PK},
doi = {10.1183/23120541.01560-2025},
journal = {ERJ Open 91桃色},
title = {The relationship between plasma favipiravir concentrations and clinical outcomes in COVID-19},
url = {http://dx.doi.org/10.1183/23120541.01560-2025},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Question addressed by the studyFavipiravir has shown efficacy against SARS-CoV-2 in patients under 60, but data linking plasma concentrations to clinical outcomes are limited. This study investigated whether favipiravir plasma concentrations influence clinical efficacy and outcomes in hospitalised COVID-19 patients and asked: how can antiviral dosing strategies be optimised to improve pandemic preparedness and treatment efficacy?Materials/patients and methodsAdult participants were drawn from the PIONEER trial, in which patients received oral favipiravir (1800mg twice daily on day 1, then 800mg twice daily for nine days) plus standard care. This analysis included patients with confirmed COVID-19 and ≥75% study adherence. Samples were collected between days 5–10 post-treatment initiation. The primary outcome was time to clinical improvement. Secondary outcomes included achievement of clinical improvement and mortality risk.ResultsOf 140 patients (50% male; mean age 59.5 [sd 14.8]), 29 (21%) reached target plasma concentrations. Mean time to improvement was 7.7 [5.9] vs 9.1 [7.2] days for target achievers vs non-achievers (p=0.26). Target was more often achieved in females (34%) than males (7%) (p=0.0002). Plasma concentration inversely correlated with BMI (r=–0.4; p<0.0001), with lower BMI in achievers (26.0 [5.1] vs 30.5 [6.9]; p=0.003). ALP and ALT levels were also lower in achievers (p=0.004 and p=0.02, respectively).Answer to the questionMost patients did not reach target favipiravir levels. Concentrations were influenced by sex, BMI, and liver function, confirming the need for pharmacokinetically guided dosing and therapeutic monitoring to optimise antiviral efficacy in future pandemic responses.
AU - Wawman,RE
AU - Shah,PL
AU - Boffito,M
AU - Tonkin,J
AU - Conway,F
AU - Tana,A
AU - Santos,BR
AU - Grinsztejn,B
AU - Ram铆rez,BC
AU - Pertinez,H
AU - Owen,A
AU - Curley,P
AU - Arshad,U
AU - Cox,H
AU - Johnson,MR
AU - Pozniak,A
AU - Pelly,M
AU - Orton,CM
AU - Bhavsar,PK
DO - 10.1183/23120541.01560-2025
PY - 2026///
SN - 2312-0541
TI - The relationship between plasma favipiravir concentrations and clinical outcomes in COVID-19
T2 - ERJ Open 91桃色
UR - http://dx.doi.org/10.1183/23120541.01560-2025
UR - https://doi.org/10.1183/23120541.01560-2025
ER -