Acetylcysteine for the Treatment of Suspected Remdesivir‐Associated Acute Liver Failure in COVID‐19: A Case Series
| Autor: | Mai Vo, Kara L. Birrer, Chancey Carothers |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 030106 microbiology Encephalopathy Remdesivir Adverse drug reactions Case Report Case Reports 030204 cardiovascular system & hematology medicine.disease_cause Toxicology Gastroenterology SARS‐CoV‐2 Acetylcysteine 03 medical and health sciences 0302 clinical medicine COVID‐19 Internal medicine medicine Coagulopathy Pharmacology (medical) Respiratory system Coronavirus medicine.diagnostic_test Septic shock business.industry digestive oral and skin physiology medicine.disease Pneumonia business Liver function tests Acute liver failure medicine.drug |
| Zdroj: | Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy Pharmacotherapy |
| ISSN: | 1875-9114 0277-0008 |
| DOI: | 10.1002/phar.2464 |
| Popis: | Remdesivir is a direct-acting nucleoside RNA polymerase inhibitor with activity against the novel severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) virus used in the treatment of coronavirus disease 2019 (COVID-19) pneumonia. Here, we present two cases of suspected remdesivir-associated acute liver failure (ALF) in which the liver failure improved after continuous infusion acetylcysteine and withdrawal of remdesivir. Both patients had significant increases in transaminases between day 3 and day 10 of remdesivir therapy accompanied by coagulopathy and encephalopathy. After initiation of continuous infusion acetylcysteine, the transaminases of both patients rapidly improved. Ultimately, one patient fully recovered while the other died of suspected septic shock. Due to its novel nature and only recent widespread use, there are very little data on the risk of ALF from remdesivir. Additionally, the data for the use of acetylcysteine to manage non-acetaminophen-induced ALF are limited. It is important to consider the risk of remdesivir-associated ALF when weighing the risk versus benefits of use, and acetylcysteine may have a role in its management. |
| Databáze: | OpenAIRE |
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