Use and Safety of Remdesivir in Kidney Transplant Recipients With COVID-19

Buxeda, Anna; Arias-Cabrales, Carlos; Pérez‐Sáez, María José; Cacho, Judit; Pelegrín, Sheila Cabello; Melilli, Edoardo; Aladrén, María José; Galeano, C.; Lorenzo, Inmaculada; Mazuecos, Auxiliadora; Saura, Isabel M; Franco, Antônio; Ruiz-Fuentes, María del Carmen; Sanchez-Cámara, Luis; Siverio, Orlando; Martín, María Luisa; González-García, Elena; López, Verónica; Martín-Moreno, Paloma Leticia; Moina, Iñigo; Berrio, Esperanza Moral; Moreso, Francesc; Pórtoles, José; Santana‐Estupiñán, Raquel; Zárraga, Sofía; Canal, Cristina; Sánchez-Álvarez, Emilio; Pascual, Julio; Crespo, Marta

doi:10.1016/j.ekir.2021.06.023

Cited by 31 publications

(31 citation statements)

References 34 publications

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“…The other recipients recovered, and no major adverse events were noted for remdesivir, including liver dysfunction [78]. A multicenter cohort study of 51 KTRs with COVID-19 who were treated with remdesivir found a mortality rate of 18.9%, with no significant hepatoxicity or systemic symptoms that resulted from the drug [79]. Forty-two KTRs with COVID-19 (19% with moderate disease and 43% with severe disease) received antiretrovirals (n = 10) or remdesivir (n = 8) as part of COVID-19 management.…”

Section: Antiviral Therapy In Covid-19mentioning

confidence: 98%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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Since its outbreak in December 2019, the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to an enormous rise in scientific response with an excess of COVID-19-related studies on the pathogenesis and potential therapeutic approaches. Solid organ transplant (SOT) recipients are a heterogeneous population with long-lasting immunosuppression as a joining element. Immunocompromised patients are a vulnerable population with a high risk of severe infections and an increased infection-related mortality rate. It was postulated that the hyperinflammatory state due to cytokine release syndrome during severe COVID-19 could be alleviated by immunosuppressive therapy in SOT patients. On the other hand, it was previously established that T cell-mediated immunity, which is significantly weakened in SOT recipients, is the main component of antiviral immune responses. In this paper, we present the current state of science on COVID-19 immunology in relation to solid organ transplantation with prospective therapeutic and vaccination strategies in this population.

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Section: Antiviral Therapy In Covid-19mentioning

confidence: 98%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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“…11 were no significant safety concerns with drug administration. 17 The study included 48 subjects taking RDV known to have comorbid diseases (cardiovascular disease, asthma, pulmonary disease, cancer, liver disease, kidney disease, diabetes and HIV). In this study 102 adverse drug reactions (ADRs) were identified.…”

Section: Resultsmentioning

confidence: 99%

“…16 T-cell mediated rejection and thrombotic microangiopathy were also known to occur with RDV. 17 Hepatobiliary disorders, acute renal failure, and nervous system disorders had also been reported in the studies we reviewed. Overall, the side effects that occurred in patients taking RDV were not significantly different from the control group,…”

Section: Safety Of Remdesivirmentioning

confidence: 92%

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The Efficacy of Remdesivir in Reducing SARS-CoV-2 Viral Load and Its Safety on COVID-19 Patients: A Systematic Review

Fauziyyah¹,

Rahmasari²,

Sauriasari³

2022

J Respirol Indones

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Background: This study aimed to examine the effectiveness of Remdesivir in reducing Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral load and its safety for antiviral therapy in Coronavirus disease 2019 (COVID-19) treatment.Methods: This systematic review used data sources from the PubMed, ProQuest, SpringerLink, and ClinicalTrial.gov databases for relevant observational and interventional studies during August 2020 to August 2021. Studies evaluating Remdesivir in adults hospitalized for COVID-19 were included in this review. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines.Results This review found 9 studies that were relevant to the study objectives. In total, 1,088 patients participated as subjects. Three studies demonstrated the effect of remdesivir in reducing SARS-CoV-2 viral load in upper and lower respiratory tract specimens. Six studies demonstrated that remdesivir was safe for use in a variety of baseline conditions (patients on hemodialysis and patients receiving kidney transplantation), had no significant hepatotoxicity, did not increase the risk of acute kidney injury, and did not increase eGFR or systemic symptoms in patients taking remdesivir.Conclusion: Remdesivir has been shown to reduce SARS-CoV-2 viral load and was safe for use as antiviral therapy in the treatment of COVID-19, but an assessment of randomized controlled trial for the effect of Remdesivir on viral load reduction was not available yet.

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“…It has been shown that 74% of remdesivir and its active metabolite are eliminated by the kidneys, and 18% are eliminated through feces. Remdesivir is not recommended in patients with severe renal insufficiency, but some studies have shown that the usual dose of remdesivir might be safe for patients with severe renal insufficiency [ 36 ], end-stage renal disease on hemodialysis [ 37 ], or kidney transplantation [ 38 ].…”

Section: Remdesivirmentioning

confidence: 99%

Pharmacology and Adverse Events of Emergency-Use Authorized Medication in Moderate to Severe COVID-19

et al. 2021

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Some effective drugs have been approved or issued an Emergency Use Authorization for the treatment of COVID-19 in hospitalized patients, but post-market surveillance is warranted to monitor adverse events. We reviewed clinical trials and case reports in patients with moderate-to-severe COVID-19 infection who received remdesivir, baricitinib, tocilizumab, or sarilumab. The drug-specific pharmacokinetics, toxicity, and drug interactions are summarized in this study. Remdesivir and baricitinib are small-molecule drugs that are mainly metabolized by the kidneys, while tocilizumab and sarilumab are monoclonal antibody drugs with metabolic pathways that are currently not fully understood. The most common adverse events of these drugs are alterations in liver function, but serious adverse events have rarely been attributed to them. Only a few studies have reported that remdesivir might be cardiotoxic and that baricitinib might cause thromboembolism. Biological agents such as baricitinib, tocilizumab, and sarilumab could inhibit the pathway of inflammatory processes, leading to immune dysregulation, so the risk of secondary infection should be assessed before prescribing. Further recognition of the pathogenic mechanism and risk factors of adverse events is essential for optimizing treatment strategies.

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Use and Safety of Remdesivir in Kidney Transplant Recipients With COVID-19

Cited by 31 publications

References 34 publications

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

The Efficacy of Remdesivir in Reducing SARS-CoV-2 Viral Load and Its Safety on COVID-19 Patients: A Systematic Review

Pharmacology and Adverse Events of Emergency-Use Authorized Medication in Moderate to Severe COVID-19

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