Liver tests abnormalities with licensed antiviral drugs for COVID-19: a narrative review.
Expert Opin Drug Saf
; 21(12): 1483-1494, 2022 Dec.
Artículo
en Inglés
| MEDLINE | ID: covidwho-2187479
ABSTRACT
INTRODUCTION:
Liver involvement in COVID-19 is multifactorial, and the three potential mechanisms are direct hepatocyte viral damage, vascular or cellular damage during the cytokine storm of severe COVID-19 and drug-induced liver injury. To date, three antivirals are licensed for the treatment of COVID-19 by most guidelines remdesivir, molnupiravir, and ritonavir-boosted nirmatrelvir. AREAS COVERED We performed a narrative review about the hepatic safety profile of the three antivirals licensed for COVID-19 treatment. We used data about hepatobiliary adverse events from English-language randomized clinical trials (RCTs). EXPERT OPINION Remdesivir was found to be potentially hepatotoxic, and liver biochemistry abnormalities were common (2-34%) but mild and reversible. Molnupiravir exhibits a favorable safety profile and the increase in aminotransferases was usually mild and reversible (up to 11% of patients in one study). Ritonavir-boosted nirmatrelvir is potentially hepatotoxic, but in the only phase 3 RCT there were no safety issues and aspartate aminotransferase/alanine aminotransferase levels increase did not exceed 2.4% of patients. All antivirals have a favorable safety profile, but they are not sufficiently studied in patients with underlying chronic kidney or liver disease. In this special populations, antivirals should be used with caution and careful monitoring during treatment should be pursued on a case-by-case basis.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Antivirales
/
COVID-19
Tipo de estudio:
Estudio experimental
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
/
Revisiones
Límite:
Humanos
Idioma:
Inglés
Revista:
Expert Opin Drug Saf
Asunto de la revista:
Farmacología
/
Terapia por drogas
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
14740338.2022.2160446
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