Population pharmacokinetics of dexamethasone in critically ill COVID-19 patients: Does inflammation play a role?

Li, Letao; Sassen, Sebastiaan; Hunfeld, Nicole; Smeets, Tim; Ewoldt, Tim M J; Berg, Sjoerd A.A. van den; Koch, Birgit C. P.; Endeman, Henrik

doi:10.1016/j.jcrc.2023.154395

Journal of Critical Care

2023

DOI: 10.1016/j.jcrc.2023.154395

|View full text |Cite

Population pharmacokinetics of dexamethasone in critically ill COVID-19 patients: Does inflammation play a role?

Letao Li

Sebastiaan Sassen

Nicole Hunfeld

et al.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2023

2024

Publication Types

Select...

Article2

Relationship

Self Cite0

Independent2

Authors

Journals

Cited by 2 publications

(1 citation statement)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Coronavirus disease 2019 (COVID-19) can cause pneumonia ranging from mild to severe grades ( 1 , 2 ). The mainstay of treatment for COVID-19 pneumonia includes antiviral drugs such as remdesivir ( 3 , 4 ) and anti-inflammatory drugs such as dexamethasone ( 5 , 6 ). Regarding non-pharmacological treatment of COVID-19 pneumonia, especially in critically ill patients, prone position ventilation (PPV) has shown positive results for most critical COVID-19 pneumonia patients using high-flow nasal cannula (HFNC) or invasive mechanical ventilation ( 7 - 10 ).…”

mentioning

confidence: 99%

Prone position versus usual care in hypoxemic COVID-19 patients in medical wards: a randomised controlled trial

Kishaba

2023

J Thorac Dis

View full text Add to dashboard Cite

mentioning

confidence: 99%

Prone position versus usual care in hypoxemic COVID-19 patients in medical wards: a randomised controlled trial

Kishaba

2023

J Thorac Dis

View full text Add to dashboard Cite

The relation between inflammatory biomarkers and drug pharmacokinetics in the critically ill patients: a scoping review

Li,

Zinger,

Sassen

et al. 2024

Crit Care

View full text Add to dashboard Cite

Background The level of inflammation alters drug pharmacokinetics (PK) in critically ill patients. This might compromise treatment efficacy. Understanding the specific effects of inflammation, measured by biomarkers, on drug absorption, distribution, metabolism, and excretion is might help in optimizing dosing strategies. Objectives This review investigates the relationship between inflammatory biomarkers and PK parameters absorption, distribution, metabolism and excretion (ADME) in critically ill patients, providing insight in the complexity of dosing drugs in critically ill patients. Method Following PRISMA guidelines, we conducted a comprehensive search of Medline, Embase, Web of Science, and Cochrane databases (January 1946–November 2023). Studies examining inflammatory biomarkers, PK parameters, or drug exposure in critically ill patients were included. Records were screened by title, abstract, and full text, with any discrepancies resolved through discussion or consultation with a third reviewer. Results Of the 4479 records screened, 31 met our inclusion criteria: 2 on absorption, 7 on distribution, 17 on metabolism, and 6 on excretion. In general, results are only available for a limited number of drugs, and most studies are done only looking at one of the components of ADME. Higher levels of inflammatory biomarkers may increase or decrease drug absorption depending on whether the drug undergoes hepatic first-pass elimination. For drug distribution, inflammation is negatively correlated with drug protein binding capacity, positively correlated with cerebrospinal fluid penetration, and negatively correlated with peritoneal penetration. Metabolizing capacity of most drugs was inversely correlated with inflammatory biomarkers. Regarding excretion, inflammation can lead to reduced drug clearance, except in the neonatal population. Conclusion Inflammatory biomarkers can offer valuable information regarding altered PK in critically ill patients. Our findings emphasize the need to consider inflammation-driven PK variability when individualizing drug therapy in this setting, at the same time research is limited to certain drugs and needs further research, also including pharmacodynamics.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Population pharmacokinetics of dexamethasone in critically ill COVID-19 patients: Does inflammation play a role?

Cited by 2 publications

References 42 publications

Prone position versus usual care in hypoxemic COVID-19 patients in medical wards: a randomised controlled trial

Prone position versus usual care in hypoxemic COVID-19 patients in medical wards: a randomised controlled trial

The relation between inflammatory biomarkers and drug pharmacokinetics in the critically ill patients: a scoping review

Contact Info

Product

Resources

About