PMID- 33315065
OWN - NLM
STAT- MEDLINE
DCOM- 20211213
LR  - 20221207
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Print)
IS  - 1058-4838 (Linking)
VI  - 73
IP  - 11
DP  - 2021 Dec 6
TI  - Remdesivir Use in the Setting of Severe Renal Impairment: A Theoretical Concern 
      or Real Risk?
PG  - e3990-e3995
LID - 10.1093/cid/ciaa1851 [doi]
LID - ciaa1851
AB  - BACKGROUND: Remdesivir (RDV) is US FDA approved for coronavirus disease 2019 
      (COVID-19) but not recommended in severe renal impairment (SRI, Creatinine 
      clearance <30mL/min or requiring renal replacement therapy). Few studies have 
      evaluated RDV in patients with SRI. METHODS: Hospitalized patients who received 
      RDV between 1 May 2020 and 31 October 2020 were analyzed in a retrospective chart 
      review. We compared incident adverse events (AEs) in patients with and without 
      SRI, including hepatotoxicity, nephrotoxicity, any reported AE, mortality, and 
      length of stay. RESULTS: Of a total of 135 patients, 20 had SRI. Patients with 
      SRI were significantly older (70 vs 54 years, P = .0001). The incidence of 
      possible AEs was 30% among those with SRI vs 11% without (P = .06). Liver 
      function test (LFT) elevations occurred in 10% vs 4% (P = .28), and serum 
      creatinine (SCr) elevations in 27% vs 6% (P = .02) of patients with SRI vs 
      without, respectively. LFT and SCr elevations were not attributed to RDV in 
      either group. Mortality and length of stay were consistent with historical 
      controls. CONCLUSIONS: RDV AEs occurred infrequently and overall were not 
      significantly different between those with and without SRI. While more of 
      patients with SRI experienced SCr elevations, 3 (75%) patients had acute kidney 
      injury prior to RDV. The use of RDV in this small series of patients with SRI 
      appeared to be relatively safe, and the potential benefit outweighed the 
      theoretical risk of liver or renal toxicity. Additional studies are needed to 
      confirm this finding.
CI  - (c) The Author(s) 2020. Published by Oxford University Press for the Infectious 
      Diseases Society of America. All rights reserved. For permissions, e-mail: 
      journals.permissions@oup.com.
FAU - Pettit, Natasha N
AU  - Pettit NN
AUID- ORCID: 0000-0002-8937-8039
AD  - Department of Pharmacy, University of Chicago Medicine, Chicago, Illinois, USA.
FAU - Pisano, Jennifer
AU  - Pisano J
AD  - Department of Medicine, Section of Infectious Diseases and Global Health, 
      University of Chicago Medicine, Chicago, Illinois, USA.
FAU - Nguyen, Cynthia T
AU  - Nguyen CT
AD  - Department of Pharmacy, University of Chicago Medicine, Chicago, Illinois, USA.
FAU - Lew, Alison K
AU  - Lew AK
AD  - Department of Pharmacy, University of Chicago Medicine, Chicago, Illinois, USA.
FAU - Hazra, Aniruddha
AU  - Hazra A
AD  - Department of Medicine, Section of Infectious Diseases and Global Health, 
      University of Chicago Medicine, Chicago, Illinois, USA.
FAU - Sherer, Renslow
AU  - Sherer R
AD  - Department of Medicine, Section of Infectious Diseases and Global Health, 
      University of Chicago Medicine, Chicago, Illinois, USA.
FAU - Mullane, Kathleen M
AU  - Mullane KM
AD  - Department of Medicine, Section of Infectious Diseases and Global Health, 
      University of Chicago Medicine, Chicago, Illinois, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (Antiviral Agents)
RN  - 3QKI37EEHE (remdesivir)
RN  - 415SHH325A (Adenosine Monophosphate)
RN  - OF5P57N2ZX (Alanine)
SB  - IM
MH  - Adenosine Monophosphate/analogs & derivatives
MH  - Alanine/analogs & derivatives
MH  - Antiviral Agents/therapeutic use
MH  - Humans
MH  - Retrospective Studies
MH  - SARS-CoV-2
MH  - *COVID-19 Drug Treatment
PMC - PMC7799321
OTO - NOTNLM
OT  - COVID-19
OT  - remdesivir
OT  - renal impairment
EDAT- 2020/12/15 06:00
MHDA- 2021/12/15 06:00
PMCR- 2021/01/11
CRDT- 2020/12/14 12:09
PHST- 2020/11/09 00:00 [received]
PHST- 2020/12/15 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2020/12/14 12:09 [entrez]
PHST- 2021/01/11 00:00 [pmc-release]
AID - 6033734 [pii]
AID - ciaa1851 [pii]
AID - 10.1093/cid/ciaa1851 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2021 Dec 6;73(11):e3990-e3995. doi: 10.1093/cid/ciaa1851.