Pharmacologic treatment of transplant recipients infected with SARS-CoV-2: considerations regarding therapeutic drug monitoring and drug-drug interactions.

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ID: 105746
2020
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Abstract
COVID-19 is a novel infectious disease caused by the severe acute respiratory distress (SARS)-corona virus-2 (SARS-CoV-2). Several therapeutic options are currently emerging but none with universal consensus or proven efficacy. Solid organ transplant recipients are perceived to be at increased risk of severe COVID-19 because of their immunosuppressed conditions due to chronic use of immunosuppressive drugs. It is therefore likely that solid organ transplant recipients will be treated with these experimental antivirals.This article is not intended to provide a systematic literature review on investigational treatments tested against COVID-19; rather, the authors aim to provide recommendations for therapeutic drug monitoring of immunosuppressive drugs in transplant recipients infected with SARS-CoV-2 based on a review of existing data in the literature.Management of drug-drug interactions between investigational anti-SARS-CoV-2 drugs and immunosuppressants is a complex task for the clinician. Adequate immunosuppression is necessary to prevent graft rejection while, if critically ill, the patient may benefit from pharmacotherapeutic interventions directed at limiting SARS-CoV-2 viral replication. Maintaining immunosuppressive drug concentrations within the desired therapeutic range requires a highly individualized approach that is complicated by the pandemic context and lack of hindsight.With the present manuscript, the authors inform the clinician about the potential interactions of experimental COVID-19 treatments with immunosuppressive drugs used in transplantation. Recommendations regarding therapeutic drug monitoring and dose adjustments in the context of COVID-19 are provided.
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elens2020pharmacologictherapeutic Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Elens, Laure;Langman, Loralie J;Hesselink, Dennis A;Bergan, Stein;Moes, Dirk Jan A R;Molinaro, Mariadelfina;Venkataramanan, Raman;Lemaitre, Florian;
Journal Therapeutic drug monitoring
Year 2020
DOI
10.1097/FTD.0000000000000761
URL
Keywords
cost effective novel corona virus non invasive safe salivary diagnostics

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