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Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study
BACKGROUND AND OBJECTIVES: Remdesivir, an antiviral drug routinely used in the treatment of COVID-19 has not yet received FDA approval for use in patients with advanced kidney disease defined as GFR < 30 mL/min/1.73 m(2). There is concern that an excipient in Veklury (Gilead’s proprietary name fo...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Author(s). Published by Elsevier Ltd on behalf of British Infection Association.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9557110/ https://www.ncbi.nlm.nih.gov/pubmed/36268055 http://dx.doi.org/10.1016/j.clinpr.2022.100207 |
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author | Stancampiano, F. Jhawar, N. Alsafi, W. Valery, J. Harris, D.M. Kempaiah, P. Shah, S. Heckman, M.G. Siddiqui, H. Libertin, C.R. |
author_facet | Stancampiano, F. Jhawar, N. Alsafi, W. Valery, J. Harris, D.M. Kempaiah, P. Shah, S. Heckman, M.G. Siddiqui, H. Libertin, C.R. |
author_sort | Stancampiano, F. |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: Remdesivir, an antiviral drug routinely used in the treatment of COVID-19 has not yet received FDA approval for use in patients with advanced kidney disease defined as GFR < 30 mL/min/1.73 m(2). There is concern that an excipient in Veklury (Gilead’s proprietary name for remdesivir) called sulfobutylether-beta-cyclodextrin (SBECD), which is renally cleared, may accumulate and reach toxic levels in patients with advanced kidney disease. The aim of this study was to summarize characteristics and incidence of adverse events of chronic kidney disease (CKD) patients who received remdesivir during hospitalization. Design, setting, participants, and measurements. We retrospectively studied patients admitted to one of several hospitals of the Mayo Clinic Foundation with the diagnosis of COVID-19 pneumonia and CKD. Laboratory values were also measured when remdesivir was first administered and stopped. All analyses were performed in the overall patient group and three separate subgroups of patients with a GFR ≥ 15, a GFR < 15 and dialysis, and a GFR < 15 and no dialysis. RESULTS: A total of 444 CKD patients who were admitted to the hospital with COVID-19 pneumonia between May 2020 and September 2021 were included. Information was collected on patient characteristics, hospitalization, and adverse events. In the overall cohort, median age was 72 years (Range: 21–100 years), 55.2 % of patients were male, and most (86.5 %) were Caucasian. CKD stage was 3 for 114 patients (25.7 %), 4 for 229 patients (51.6 %), and 5 for 101 patients (22.7 %). A total of 146 patients (32.9 %) were admitted to the ICU, 103 (23.2 %) died in the hospital, and 120 (27.0 %) were on dialysis. The proportion of patients with an adverse event did not differ dramatically between the GFR ≥ 15 (20.9 %), GFR < 15 and dialysis (30.2 %), and GFR < 15 and no dialysis (32.3 %) groups (P = 0.12). CONCLUSION: Our results suggest that the use of remdesivir in patients with very severe CKD is safe, even in those who are not on renal replacement therapy. |
format | Online Article Text |
id | pubmed-9557110 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Author(s). Published by Elsevier Ltd on behalf of British Infection Association. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95571102022-10-16 Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study Stancampiano, F. Jhawar, N. Alsafi, W. Valery, J. Harris, D.M. Kempaiah, P. Shah, S. Heckman, M.G. Siddiqui, H. Libertin, C.R. Clin Infect Pract Case Reports and Series BACKGROUND AND OBJECTIVES: Remdesivir, an antiviral drug routinely used in the treatment of COVID-19 has not yet received FDA approval for use in patients with advanced kidney disease defined as GFR < 30 mL/min/1.73 m(2). There is concern that an excipient in Veklury (Gilead’s proprietary name for remdesivir) called sulfobutylether-beta-cyclodextrin (SBECD), which is renally cleared, may accumulate and reach toxic levels in patients with advanced kidney disease. The aim of this study was to summarize characteristics and incidence of adverse events of chronic kidney disease (CKD) patients who received remdesivir during hospitalization. Design, setting, participants, and measurements. We retrospectively studied patients admitted to one of several hospitals of the Mayo Clinic Foundation with the diagnosis of COVID-19 pneumonia and CKD. Laboratory values were also measured when remdesivir was first administered and stopped. All analyses were performed in the overall patient group and three separate subgroups of patients with a GFR ≥ 15, a GFR < 15 and dialysis, and a GFR < 15 and no dialysis. RESULTS: A total of 444 CKD patients who were admitted to the hospital with COVID-19 pneumonia between May 2020 and September 2021 were included. Information was collected on patient characteristics, hospitalization, and adverse events. In the overall cohort, median age was 72 years (Range: 21–100 years), 55.2 % of patients were male, and most (86.5 %) were Caucasian. CKD stage was 3 for 114 patients (25.7 %), 4 for 229 patients (51.6 %), and 5 for 101 patients (22.7 %). A total of 146 patients (32.9 %) were admitted to the ICU, 103 (23.2 %) died in the hospital, and 120 (27.0 %) were on dialysis. The proportion of patients with an adverse event did not differ dramatically between the GFR ≥ 15 (20.9 %), GFR < 15 and dialysis (30.2 %), and GFR < 15 and no dialysis (32.3 %) groups (P = 0.12). CONCLUSION: Our results suggest that the use of remdesivir in patients with very severe CKD is safe, even in those who are not on renal replacement therapy. The Author(s). Published by Elsevier Ltd on behalf of British Infection Association. 2022-11 2022-10-13 /pmc/articles/PMC9557110/ /pubmed/36268055 http://dx.doi.org/10.1016/j.clinpr.2022.100207 Text en © 2022 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Case Reports and Series Stancampiano, F. Jhawar, N. Alsafi, W. Valery, J. Harris, D.M. Kempaiah, P. Shah, S. Heckman, M.G. Siddiqui, H. Libertin, C.R. Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study |
title | Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study |
title_full | Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study |
title_fullStr | Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study |
title_full_unstemmed | Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study |
title_short | Use of remdesivir for COVID-19 pneumonia in patients with advanced kidney disease: A retrospective multicenter study |
title_sort | use of remdesivir for covid-19 pneumonia in patients with advanced kidney disease: a retrospective multicenter study |
topic | Case Reports and Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9557110/ https://www.ncbi.nlm.nih.gov/pubmed/36268055 http://dx.doi.org/10.1016/j.clinpr.2022.100207 |
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