Transient liver enzyme derangement following Remdesivir use: a case series
DOI:
https://doi.org/10.53411/jpadr.2021.2.3.7Keywords:
Remdesivir, liver enzyme elevation, drug-induced liver injury (DILI), de-challengeAbstract
Introduction: Remdesivir, a nucleotide analog RNA polymerase inhibitor, which was originally evaluated in clinical trials to thwart the Ebola outbreak in 2014, has shown in vitro efficacy against SARS-CoV-2. Experience on its efficacy and safety in COVID-19 is accumulating. In COVID-19, Remdesivir therapy is given intravenously for 5 to 10 days and is frequently accompanied by transient, reversible mild-to-moderate elevations in serum aminotransferase levels but has been only rarely linked to instances of clinically apparent liver injury as a drug-induced liver injury (DILI). It may be caused by direct toxicity possibly due to inhibition of mitochondrial RNA polymerase.
Case Presentation: Here, we have discussed two cases where liver enzyme levels increased dramatically on the day next after initiating Remdesivir. Case one and two showed grade 4 and grade 3 hepatotoxicity respectively. In both cases, a positive de-challenge was observed and concomitant drugs were not considered to be confounders.
Conclusions: Hence, Remdesivir has a causal relationship with the occurrence of this adverse drug reaction.
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Copyright (c) 2021 Harsh H. Patel, Harsha D. Makwana, Karan B. Shah, Supriya D. Malhotra
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