Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
Br J Clin Pharmacol. 2021 Nov;87(11):4450-4454. doi: 10.1111/bcp.14831. Epub 2021 May 4.
For the treatment of Covid-19 patients with remdesivir, poor renal and liver function were both exclusion criteria in randomized clinical trials and contraindication for treatment. Also, nephrotoxicity and hepatotoxicity are reported as adverse events. We retrospectively reviewed renal and liver functions of Covid-19 103 patients who received remdesivir in the 15 days after treatment initiation. Approximately 20% of the patient population met randomized clinical trial exclusion criteria. In total, 11% of the patients had a decrease in estimated glomerular filtration rate >10 mL/min/1.73m . Also, 25 and 35% had increased alanine transaminase and aspartate transaminase levels, respectively. However, serious adverse events were limited. Therefore, based on these preliminary results, contraindications based on kidney and liver function should not be absolute for remdesivir treatment in patients with Covid-19 if these functions are monitored regularly. A larger patient cohort is warranted to confirm our results.
对于接受瑞德西韦治疗的新冠-19 患者，肾功能和肝功能不良在随机临床试验中均为排除标准，也是治疗的禁忌症。此外，肾毒性和肝毒性被报道为不良事件。我们回顾性分析了 103 例新冠-19 患者在治疗开始后 15 天内接受瑞德西韦治疗的肾功能和肝功能。大约 20%的患者人群符合随机临床试验排除标准。总的来说，有 11%的患者肾小球滤过率估计值下降超过 10 mL/min/1.73m2。此外，分别有 25%和 35%的患者丙氨酸转氨酶和天冬氨酸转氨酶水平升高。然而，严重不良事件有限。因此，基于这些初步结果，如果定期监测这些功能，基于肾功能和肝功能的禁忌症对于新冠-19 患者的瑞德西韦治疗不应是绝对的。需要更大的患者队列来证实我们的结果。
