Clinical characteristics and pharmacokinetics of PAXLOVID in COVID-19 patients with hematological tumor
et al., Medical Review, doi:10.1515/mr-2023-0068, Mar 2024
Retrospective 12 hospitalized COVID-19 patients with hematological malignancies showing one death and two cases of liver injury with paxlovid treatment. The study focused on pharmacokinetics, finding nirmatrelvir concentrations approximately 3-fold higher than those observed in clinical trials, with substantial individual variability. Two patients experienced liver injury with ALT levels increased 2.2 and 7.5 times baseline, with one patient having extremely high nirmatrelvir concentrations. Eight patients experienced viral rebound with a median of 7 days. No correlation was found between nirmatrelvir concentration and duration of viral shedding.
Resistance. Variants may be resistant to paxlovid1-8. Use may promote the emergence of variants that weaken host immunity and potentially contribute to long COVID9. Confounding by contraindication. Hoertel et al. find that over 50% of patients that died had a contraindication for the use of Paxlovid10. Retrospective studies that do not exclude contraindicated patients may significantly overestimate efficacy. Black box warning. The FDA notes that severe, life-threatening, and/or fatal adverse reactions due to drug interactions have been reported in patients treated with paxlovid11. Kidney and liver injury. Studies show significantly increased risk of acute kidney injury12 and liver injury13.
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Liu et al., 4 Mar 2024, retrospective, China, peer-reviewed, 7 authors.
Contact: libozhao2011@163.com, zhaorongsheng@bjmu.edu.cn.
Clinical characteristics and pharmacokinetics of PAXLOVID in COVID-19 patients with hematological tumor
Medical Review, doi:10.1515/mr-2023-0068
min means collected from different cycle of Paxlovid use. d All patients were treated with corticosteroid.
References
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Liu, Clinical characteristics and pharmacokinetics of PAXLOVID
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