Pharmacology and Adverse Events of Emergency-Use Authorized Medication in Moderate to Severe COVID-19

Pharmaceuticals

Yan-Chiao Mao¹  Kuo-Lung Lai²  Jen-Yu Hsu³  Po-Yu Liu³ 

[1] Department of Emergency Medicine, Division of Clinical Toxicology, Taichung Veterans General Hospital, Taichung 407219, Taiwan;Department of Internal Medicine, Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 407219, Taiwan;Department of Internal Medicine, Division of Infectious Diseases, Taichung Veterans General Hospital, Taichung 407219, Taiwan;

关键词: adverse event;    baricitinib;    COVID-19;    remdesivir;    sarilumab;    tocilizumab;   

DOI  :  10.3390/ph14100955

来源: DOAJ

【 摘 要 】

Some effective drugs have been approved or issued an Emergency Use Authorization for the treatment of COVID-19 in hospitalized patients, but post-market surveillance is warranted to monitor adverse events. We reviewed clinical trials and case reports in patients with moderate-to-severe COVID-19 infection who received remdesivir, baricitinib, tocilizumab, or sarilumab. The drug-specific pharmacokinetics, toxicity, and drug interactions are summarized in this study. Remdesivir and baricitinib are small-molecule drugs that are mainly metabolized by the kidneys, while tocilizumab and sarilumab are monoclonal antibody drugs with metabolic pathways that are currently not fully understood. The most common adverse events of these drugs are alterations in liver function, but serious adverse events have rarely been attributed to them. Only a few studies have reported that remdesivir might be cardiotoxic and that baricitinib might cause thromboembolism. Biological agents such as baricitinib, tocilizumab, and sarilumab could inhibit the pathway of inflammatory processes, leading to immune dysregulation, so the risk of secondary infection should be assessed before prescribing. Further recognition of the pathogenic mechanism and risk factors of adverse events is essential for optimizing treatment strategies.

【 授权许可】

Unknown