Safety, Efficacy and Relapse of Nirmatrelvir-Ritonavir in Kidney Transplant Recipients Infected with SARS-CoV-2.
(2022) Kidney International Reports — Vol. 7, n° 11, p. 2356-2363 (2022)
Files
Devresse-2022inpress-Safetyefficacyandrelapse.pdf
Open Access - Adobe PDF
- 1.21 MB
Details
- Authors
- Abstract
- Nirmatrelvir-ritonavir (NR) has demonstrated its efficacy to decrease the risk of progression to severe COVID-19 in high-risk patients. However, evidence in infected kidney transplant recipients (KTRs) is lacking. Moreover, NR has significant and potentially harmful interactions with calcineurin inhibitors (CNIs). In this single-center retrospective study, we included all KTRs treated with NR from April 28 to June 3, 2022. A standard management strategy of CNIs dose adaptation (discontinuation of tacrolimus 12 hours before the start of NR and administration of 20% the cyclosporine dose) and laboratory follow-up was applied. Fourteen patients were included. Compared to day-0 (day before NR initiation), day-7 plasma creatinine concentrations and SARS-CoV-2 viral loads were similar (p = 0.866) and decreased (p=0.002), respectively. CNIs trough concentrations at the end of the treatment were satisfactory, with nevertheless high individual variability. After a median follow-up time of 34 days, no death nor viral pneumonia were observed. However, 2 patients experienced early SARS-CoV-2 infection relapses (at day-10 and day-21) associated with an increase in SARS-CoV-2 viral loads. NR can be used in KTRs but requires a strict protocol of drug adaptation. We observed two cases of early relapse after NR treatment that need further investigations.
- Affiliations
Citations
Devresse, A., Briol, S., De Greef, J., Lemaitre, F., Boland, L., Haufroid, V., Scohy, A., Kabamba-Mukadi, B., Yombi, J. C., Belkhir, L., Darius, T., Buemi, A., De Potter, K., Mantegazza, R., Bearzatto, B., Goffin, E., & Kanaan, N. (2022). Safety, Efficacy and Relapse of Nirmatrelvir-Ritonavir in Kidney Transplant Recipients Infected with SARS-CoV-2. Kidney International Reports, 7(11), 2356-2363. https://doi.org/10.1016/j.ekir.2022.08.026 (Original work published 2022)