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Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System

Remdesivir was recommended for hospitalized patients with COVID-19. As already reported in the Summary of Product Characteristics, most of remdesivir’s safety concerns are hepatoxicity and nephrotoxicity related. However, some cases have raised concerns regarding the potential cardiac events associa...

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Autores principales: Rafaniello, Concetta, Ferrajolo, Carmen, Sullo, Maria Giuseppa, Gaio, Mario, Zinzi, Alessia, Scavone, Cristina, Gargano, Francesca, Coscioni, Enrico, Rossi, Francesco, Capuano, Annalisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308754/
https://www.ncbi.nlm.nih.gov/pubmed/34202350
http://dx.doi.org/10.3390/ph14070611
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author Rafaniello, Concetta
Ferrajolo, Carmen
Sullo, Maria Giuseppa
Gaio, Mario
Zinzi, Alessia
Scavone, Cristina
Gargano, Francesca
Coscioni, Enrico
Rossi, Francesco
Capuano, Annalisa
author_facet Rafaniello, Concetta
Ferrajolo, Carmen
Sullo, Maria Giuseppa
Gaio, Mario
Zinzi, Alessia
Scavone, Cristina
Gargano, Francesca
Coscioni, Enrico
Rossi, Francesco
Capuano, Annalisa
author_sort Rafaniello, Concetta
collection PubMed
description Remdesivir was recommended for hospitalized patients with COVID-19. As already reported in the Summary of Product Characteristics, most of remdesivir’s safety concerns are hepatoxicity and nephrotoxicity related. However, some cases have raised concerns regarding the potential cardiac events associated with remdesivir; therefore, the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency requested to investigate all available data. Therefore, we analyzed all Individual Case Safety Reports (ICSRs) collected in the EudraVigilance database focusing on cardiac adverse events. From April to December 2020, 1375 ICSRs related to remdesivir were retrieved from EudraVigilance, of which 863 (62.8%) were related to male and (43.3%) adult patients. A total of 82.2% of all AEs (N = 2604) was serious and one third of the total ICSRs (N = 416, 30.3%) had a fatal outcome. The most frequently reported events referred to hepatic/hepatobiliary disorders (19.4%,), renal and urinary disorders (11.1%) and cardiac events (8.4%). Among 221 cardiac ICSRs, 69 reported fatal outcomes. Other drugs for cardiovascular disorders were reported as suspected/concomitant together with remdesivir in 166 ICSRs (75.1%), 62 of which were fatal. Moreover, the mean time to overall cardiac event was 3.3 days (±2.2). Finally, disproportionality analysis showed a two-fold increased risk of reporting a cardiac adverse event associated with remdesivir compared to both hydroxychloroquine and azithromycin. This study showed that remdesivir could be associated to risk of cardiac events, suggesting a potential safety signal which has not been completely evaluated yet. Further studies are needed to confirm these findings.
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spelling pubmed-83087542021-07-25 Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System Rafaniello, Concetta Ferrajolo, Carmen Sullo, Maria Giuseppa Gaio, Mario Zinzi, Alessia Scavone, Cristina Gargano, Francesca Coscioni, Enrico Rossi, Francesco Capuano, Annalisa Pharmaceuticals (Basel) Article Remdesivir was recommended for hospitalized patients with COVID-19. As already reported in the Summary of Product Characteristics, most of remdesivir’s safety concerns are hepatoxicity and nephrotoxicity related. However, some cases have raised concerns regarding the potential cardiac events associated with remdesivir; therefore, the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency requested to investigate all available data. Therefore, we analyzed all Individual Case Safety Reports (ICSRs) collected in the EudraVigilance database focusing on cardiac adverse events. From April to December 2020, 1375 ICSRs related to remdesivir were retrieved from EudraVigilance, of which 863 (62.8%) were related to male and (43.3%) adult patients. A total of 82.2% of all AEs (N = 2604) was serious and one third of the total ICSRs (N = 416, 30.3%) had a fatal outcome. The most frequently reported events referred to hepatic/hepatobiliary disorders (19.4%,), renal and urinary disorders (11.1%) and cardiac events (8.4%). Among 221 cardiac ICSRs, 69 reported fatal outcomes. Other drugs for cardiovascular disorders were reported as suspected/concomitant together with remdesivir in 166 ICSRs (75.1%), 62 of which were fatal. Moreover, the mean time to overall cardiac event was 3.3 days (±2.2). Finally, disproportionality analysis showed a two-fold increased risk of reporting a cardiac adverse event associated with remdesivir compared to both hydroxychloroquine and azithromycin. This study showed that remdesivir could be associated to risk of cardiac events, suggesting a potential safety signal which has not been completely evaluated yet. Further studies are needed to confirm these findings. MDPI 2021-06-25 /pmc/articles/PMC8308754/ /pubmed/34202350 http://dx.doi.org/10.3390/ph14070611 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rafaniello, Concetta
Ferrajolo, Carmen
Sullo, Maria Giuseppa
Gaio, Mario
Zinzi, Alessia
Scavone, Cristina
Gargano, Francesca
Coscioni, Enrico
Rossi, Francesco
Capuano, Annalisa
Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System
title Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System
title_full Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System
title_fullStr Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System
title_full_unstemmed Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System
title_short Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System
title_sort cardiac events potentially associated to remdesivir: an analysis from the european spontaneous adverse event reporting system
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308754/
https://www.ncbi.nlm.nih.gov/pubmed/34202350
http://dx.doi.org/10.3390/ph14070611
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