Evidence map›Paper›PMID 41869741›Full record

Trial reportBritish journal of clinical pharmacology2026

Population pharmacokinetic/pharmacodynamic modelling to evaluate favipiravir in combination with lopinavir-ritonavir in patients with COVID-19.

Akosua A Agyeman, Laura Buggiotti, Li-An K Brown, Jose A Guerra-Assuncao, Japhette E Kembou-Ringert, Wen Y Mak, Judith Breuer, David M Lowe, Joseph F Standing, FLARE Investigators

Abstract readRandomized Controlled TrialClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Akosua A AgyemanInfection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID https://orcid.org/0000-0002-8866-3524
Laura BuggiottiInfection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.
Li-An K BrownInstitute of Immunity and Transplantation, University College London, Royal Free Campus, London, UK.
Jose A Guerra-AssuncaoInfection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.
Japhette E Kembou-RingertInfection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.
Wen Y MakClinical Research Centre, Penang General Hospital, George Town, Penang, Malaysia.ORCID https://orcid.org/0000-0002-8346-2934
Judith BreuerInfection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.
David M LoweInstitute of Immunity and Transplantation, University College London, Royal Free Campus, London, UK.
Joseph F StandingInfection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID https://orcid.org/0000-0002-4561-7173
FLARE Investigators

Funding

LifeArc COVID0005Medical Research Council MRC MR/M008665
6 · The paper itself

Abstract

aimsThe repurposed use of favipiravir in COVID-19 has been reported to have limited clinical efficacy, yet it has been widely used in some countries. Favipiravir causes mutagenesis in RNA viruses, and it is currently unknown whether it may have a measurable effect on the virus in humans. In this study, we report the secondary endpoints from the phase 2a randomized, double-blind, 2 × 2 factorial placebo-controlled FLARE trial, which studied the combination of favipiravir and lopinavir-ritonavir.

methodsPopulation pharmacokinetic and viral dynamic models including data from 59 and 235 participants respectively were developed to assess the drug effect of favipiravir in combination with lopinavir-ritonavir. Viral whole-genome sequencing was performed.

resultsThe final joint model consisted of a slope-intercept exponential decay viral dynamic model and a one-compartment model with first-order absorption and elimination for favipiravir pharmacokinetics. The mean death rate of infected cells (δ) was 0.96 day

conclusionsOur findings suggest that favipiravir does not have antiviral activity at the dose used in our study, and further work to understand the mechanistic basis of the drug-drug interaction with lopinavir-ritonavir is required.

Indexed as

AmidesAntiviral AgentsCOVID-19 Drug TreatmentLopinavirPyrazinesRitonavirAdultCOVID-19Double-Blind MethodDrug CombinationsDrug InteractionsDrug Therapy, CombinationFemaleHumansMaleMiddle AgedAmidesAntiviral AgentsDrug CombinationsfavipiravirLopinavirlopinavir-ritonavir drug combinationPyrazinesRitonavirCOVID‐19favipiravirlopinavir–ritonavirpopulation pharmacokinetic/pharmacodynamic modellingviral whole‐genome sequence

Identifiers

PMID41869741
PMCPMC13304270

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.