Safety, efficacy, and pharmacokinetics of nirmatrelvir and ritonavir in patients with severe COVID-19 and renal impairment : A case report
© 2024 Published by Elsevier Ltd..
Nirmatrelvir/ritonavir (N/r) has received emergency use authorization for mild-to-moderate COVID-19 treatment in adult and pediatric patients (aged and weighing at least 12 years and 40 kg, respectively) presenting positive direct SARS-CoV-2 viral testing results and a high risk of disease progression to severe COVID-19. However, information remains limited concerning the corresponding drug safety, efficacy, and pharmacokinetics in patients with severe renal impairment. In this study, we present the case of a 91-year-old Chinese man who, despite exhibiting recurrent positive SARS-CoV-2 results and progression to severe COVID-19, was treated with N/r. Due to severe renal impairment and concurrent administration of continuous renal replacement therapy (continuous venovenous hemofiltration) during medication, we aimed to determine the serum N/r drug concentration in the patient. Our analysis revealed Cmax values of 12.42 and 2.001 μg/mL for nirmatrelvir and ritonavir, respectively. Despite the particularly high serum N/r concentration in this patient, the clinical and laboratory test analyses confirmed that the treatment was safe and effective. Nevertheless, N/r should be used with caution and at lower doses in patients with severe renal impairment to avoid potential high N/r concentration-related adverse reactions and events.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Heliyon - 10(2024), 6 vom: 30. März, Seite e28069 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zheng, Ren [VerfasserIn] |
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| Links: |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Revised 23.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.heliyon.2024.e28069 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370052889 |
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| 245 | 1 | 0 | |a Safety, efficacy, and pharmacokinetics of nirmatrelvir and ritonavir in patients with severe COVID-19 and renal impairment |b A case report |
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| 520 | |a Nirmatrelvir/ritonavir (N/r) has received emergency use authorization for mild-to-moderate COVID-19 treatment in adult and pediatric patients (aged and weighing at least 12 years and 40 kg, respectively) presenting positive direct SARS-CoV-2 viral testing results and a high risk of disease progression to severe COVID-19. However, information remains limited concerning the corresponding drug safety, efficacy, and pharmacokinetics in patients with severe renal impairment. In this study, we present the case of a 91-year-old Chinese man who, despite exhibiting recurrent positive SARS-CoV-2 results and progression to severe COVID-19, was treated with N/r. Due to severe renal impairment and concurrent administration of continuous renal replacement therapy (continuous venovenous hemofiltration) during medication, we aimed to determine the serum N/r drug concentration in the patient. Our analysis revealed Cmax values of 12.42 and 2.001 μg/mL for nirmatrelvir and ritonavir, respectively. Despite the particularly high serum N/r concentration in this patient, the clinical and laboratory test analyses confirmed that the treatment was safe and effective. Nevertheless, N/r should be used with caution and at lower doses in patients with severe renal impairment to avoid potential high N/r concentration-related adverse reactions and events | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Nirmatrelvir/ritonavir | |
| 650 | 4 | |a Pharmacokinetics | |
| 650 | 4 | |a Severe COVID-19 patients | |
| 650 | 4 | |a Severe renal impairment | |
| 700 | 1 | |a Fan, Xudong |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Feng |e verfasserin |4 aut | |
| 700 | 1 | |a Ye, Xiqian |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Junjie |e verfasserin |4 aut | |
| 700 | 1 | |a Yuan, Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Cai, Xinjun |e verfasserin |4 aut | |
| 700 | 1 | |a Wei, Anqi |e verfasserin |4 aut | |
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