Trial reportThe Journal of infectious diseases2025
A Viroimmunologic Model to Characterize the Antiviral Effect of Molnupiravir in Outpatients Infected With SARS-CoV-2: Implication for Treatment Duration.
Trial report in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Clinical trial simulation of antiviral drugs.Journal of virology · 2026Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundThe antiviral efficacy of molnupiravir against SARS-CoV-2 is controversial. Here, we develop a model integrating viral and immune dynamics to characterize the mechanism of action of molnupiravir in vivo and its impact on viral dynamics during and after treatment.
methodsWe analyzed data from the PANORAMIC trial, where 577 outpatients were randomized shortly after symptom onset to receive usual care or molnupiravir for 5 days, with viral and immunologic data collected within 2 weeks. We developed a mathematical model that characterized virus-host interaction, accounting for the impact of molnupiravir on viral replication and mutagenesis. The model was used to explore the impact of longer treatment duration.
resultsMolnupiravir reduced RNA replication with an efficacy that reached 93% at the end of a 5-day treatment. This effect was mediated through 2 pathways: 1 that increased transition mutation frequency and 1 that directly inhibited viral production. Accordingly, 5-day treatment shortened the median time to clearance of RNA and infectious virus by approximately 2 days. Ten-day treatment could reduce the time to RNA clearance by 5 days and the occurrence of viral rebounds. Longer treatment durations might be needed for postexposure prophylaxis.
conclusionsOur model suggests that molnupiravir acts primarily on viral replication, and not specifically on viral infectivity. Longer administration of molnupiravir may reduce the rebound rate, shortening the time to viral clearance.
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