Valoración del uso del remdesivir para el tratamiento de la COVID-19

Autores/as

DOI:

https://doi.org/10.5281/zenodo.11492896

Palabras clave:

acciones farmacológicas, antivirales, covid-19, farmacocinética

Resumen

Introducción: el remdesivir es un profármaco de amplio espectro antiviral que se utiliza para el tratamiento de pacientes hospitalizados por COVID-19.

Objetivo: valorar la evidencia científica disponible sobre el uso del remdesivir en el tratamiento de la COVID-19.

Métodos: se realizó una revisión de la bibliografía en las bases de datos disponibles en español e inglés de la Biblioteca Virtual de Salud, MEDLINE, Lilacs, SciELO, EBSCO y el buscador Google Académico desde 2018 hasta el 2021. Se seleccionaron 50 artículos con la información necesaria.

Desarrollo: las terapias con inhibidores de nucleótidos/nucleósidos dirigidos contra la polimerasa ADN y ARN, pudieran constituirse en los tratamientos medulares de la terapia antiviral. Cuando el remdesivir se convierte en un metabolito activo provoca la terminación de la cadena de ARN viral e inhibe la replicación viral, lo que ha sido confirmado en estudios pre-clínicos. La información disponible de los ensayos clínicos es controversial, sin embargo, se ha podido comprobar que mejora el tiempo de recuperación de los pacientes y la supervivencia. Aunque ha mostrado un perfil de seguridad favorable, aún se reportan reacciones adversas. El esquema de tratamiento de cinco días muestra buena eficacia y menor tasa de interrupción por efectos adversos; la vía inhalatoria parece mejorar la biodisponibilidad del remdesivir en los tejidos pulmonares.

Conclusiones: el remdesivir está recomendado para el tratamiento de enfermos hospitalizados con COVID-19 y requerimientos de oxígeno, sin embargo, se requieren más investigaciones en seres humanos para confirmar su eficacia clínica en estos pacientes.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Raymel Arceo Naranjo, Hospital Cubano de Qatar.

Licenciado en Ciencias Farmacéuticas. Farmacéutico Clínico. Profesor Asistente. Hospital Cubano de Qatar.

Ivón González Blanco, Universidad de La Habana. La Habana.

Doctor en Ciencias Farmacéuticas. Profesor Auxiliar. Instituto de Farmacia y Alimentos. Universidad de La Habana. La Habana.

Milena Díaz Molina, Universidad de La Habana.

Doctor en Ciencias Farmacéuticas. Profesor Titular. Instituto de Farmacia y Alimentos. Universidad de La Habana.

Citas

Harapan H, Itoh N, Yufika A, Winardi W, Keam S, Te H, et al. Coronavirus disease 2019 (COVID-19): A literature review. J. Infect. Public Health [Internet]. 2020 [citado 23 Mar 2021];13(5):667-73. Disponible en: https://www.sciencedirect.com/science/article/pii/S1876034120304329

Castella M, Rajnik M, Cuomo A, Dulebohn SC, Napoli RD. Features, Evaluation and Treatment of coronavirus (Covid-19). NLM. En: StatPearls [Internet]. Florida: StatPearls Publishing. 2021 [citado 20 Abr 2021]; Disponible en: https://apps.dtic.mil/sti/pdfs/AD1127230.pdf

Daou F, Sleymane GA, Brado DA, Khanafer N, Tobaiqy M, Faraj AA. The History, Efficacy, and Safety of Potential Therapeutics: A Narrative Overview of the Complex Life of Covid-19. Int.

J. Environ. Res. Public Health [Internet]. 2021 [citado 20 Abr 2021];18:[aprox. 16 p.]. Disponible en: https://mdpi-res.com/d_attachment/ijerph/ijerph-18-00955/article_deploy/ijerph-18-00955.pdf?version=1611325090

Wu J, Liang B, Chen C, Wang H, Fang Y, Shen S, et al. SARS-CoV-2 infection induces sustained humoral immune response in convalescent patients following symptomatic COVID-19. Nat Comm [Inetrnet]. 2021 [citado 20 Abr 2021];12:[aprox. 9 p.] Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985370/pdf/41467_2021_Article_22034.pdf

Jirjees F, Saad AK, Hano ZA, Hatahet T, Obaidi HA, Bashi YD. COVID-19 Treatment Guidelines: Do They Really Reflects Best Medical Practices to Manage the Pandemic? Inf Dis Rep [Internet]. 2021 Feb 24 [citado 15 May 2021];13(2):259-84. Disponible en: https://mdpi-res.com/d_attachment/idr/idr-13-00029/article_deploy/idr-13-00029.pdf?version=1617938877

Eastman RT, Roth JS, Brimacombe KR, Simeonov A, Shen M, Patnaik S, et. al. Remdesivir: A Review of its Discovery and Development Leading to Emergency Use Authorization for Treatment of Covid-19. ACS Cent Sci [Internet]. 2020 [citado 13 Abr 2021];6(5):672-83. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202249/pdf/oc0c00489.pdf

Wang C, Wang Z, Wang G, Lau JAY, Zang K, Li W. COVID-19 in early 2021: current status and looking forward. Signal Transduct Target Ther [Internet]. 2021 [citado 13 Abr 2021];6:[aprox. 14 p.]. Disponible es: https://www.nature.com/articles/s41392-021-00527-1.pdf

Díaz-Catrillón F, Toro-Montoya AI. SARS-CoV-2/Covid-19: el virus la enfermedad y la pandemia. EMC [Internet]. 2020 [citado 13 Abr 2021];24(3):183-205. Disponible en: https://docs.bvsalud.org/biblioref/2020/05/1096519/covid-19.pdf

National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. NIH [Internet]. [citado 13 Abr 2021]. Disponible en: https://www.covid19treatmentguidelines.nih.gov/

Sun D. Remdesivir for treatment of Covid-19: Combination of Pulmonary and IV Administration May Offer Aditional Benefits. AAPS J [Internet]. 2020 [citado 13 Abr 2021];22(4):[aprox. 6 p.]. Disponible es: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250281/pdf/12248_2020_Article_459.pdf

Mehta N, Mazer-Amirshahi M, Alkindi N, Pourmand A. Pharmacotherapy in Covid-19; A narrative review for emergency providers. Am J Emerg Med [Internet]. 2020 [citado 13 Abr 2021];38(7):1488-93. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158837/pdf/main.pdf

Gómez JT, Dieguez RG, Pérez MA. Alternativas terapéuticas para el manejo de la Covid-19. Ciencias Clínicas y Patológicas. Rev haban cienc méd [Internet]. 2020 [citado 13 Abr 2021];19(Supl. 1):[aprox. 15 p.]. Disponible en: http://scielo.sld.cu/pdf/rhcm/v19s1/1729-519X-rhcm-19-s1-e3328.pdf

Lu G, Zhang X, Zheng W, Sun J, Hua Lan, Xu L, et al. Development of a Simple In Vitro Assay To Identify and Evaluate Nucleotide Analogs against SARS-CoV-2 RNA Dependent RNA Polymerase. Antimicrob Agents Chemother [Internet]. 2020 [citado 13 Abr 2021];65(1):e1508-20. Disponible en: https://journals.asm.org/doi/pdf/10.1128/AAC.01508-20

Kumar I. A review on pharmacokinetics, pharmacodynamics and clinical aspects of remdesivir and favipiravir for the treatment of coronavirus diseases. Journal of Drug Delivery and Therapeutics [Internet]. 2021 [citado 13 Abr 2021];11(1):121-29. Disponible en: https://www.researchgate.net/profile/Inder-Kumar-2/publication/348554319_A_review_on_pharmacokinetics_pharmacodynamics_and_clinical_aspects_of_remdesivir_and_favipiravir_for_the_treatment_of_coronavirus_disease/links/6003b07692851c13fe17f5c4/A-review-on-pharmacokinetics-pharmacodynamics-and-clinical-aspects-of-remdesivir-and-favipiravir-for-the-treatment-of-coronavirus-disease.pdf

Byléhn F, Menéndez CA, Pérez-Lemus GR, Alvarado W, De Pablo JJ. Modeling the Binding Mechanism of Remdesivir, Favipiravir, and Ribavirin to SARS-CoV-2 RNA-Dependent RNA Polymerase. ACS Cent Sci [Internet]. 2017 [citado 13 Abr 2021];7(1):164-74. Disponible en: https://pubs.acs.org/doi/pdf/10.1021/acscentsci.0c01242

Rezagholizadeh A, Khiali S, SarbaKhsh P, Entezari–Maleki T. Remdesivir for Treatment of Covid-19: an updated systematic review and meta-analysis. Eur J Pharmacol [Internet]. 2021 [citado 13 Abr 2021];897:[aprox. 8 p.]. Disponible en: https://www.sciencedirect.com/science/article/pii/S0014299921000790

Davis M, Osborne V, Lane S, Roy D, Dhanda S, Evans A, et al. Remdesivir in Treatment of Covid-19: A Systematic Benefic-Risk Assessment. Drug Saf [Internet]. 2020 [citado 13 Abr 2021];43(7):645-56. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255634/pdf/40264_2020_Article_952.pdf

Aleissa MM, Silverman EA, Paredes AL, Nutt CT, Richterman A, Marty F. New Perpective of Antimicrobial Agents: Remdesivir Treatment for Covid-19. Antimicrob Agents Chemother [Internet]. 2020 [citado 13 Abr 2021];65(1):[aprox. 18 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927874/pdf/AAC.01814-20.pdf

Dal-Ré R, Banzi R, Georgin-Lavialle S, Porcher R, Sofat R, Zeitlinger M, et al. Remdesivir for Covid-19 in Europe: will it provide value for money? Comment. Lancet [Internet]. 2021 [citado 13 Abr 2021];9(2):127-28. Disponible en: https://www.sciencedirect.com/sdfe/reader/pii/S2213260020305683/pdf

Xu Y, Barauskas O, Kim C, Babusis D, Murakami E, Kornyeyev D, et al. Off-Target In Vitro Profiling Demostrates that Remdesivir Is a Highly Selective Antiviral Agent. ASM AAC [Internet]. 2021 [citado 13 Abr 2021];65(2):[aprox. 14 p.]. Disponible en: https://journals.asm.org/doi/pdf/10.1128/aac.02237-20

Bhimraj A, Morgan RL, Shumarker AH, Lavergne V, Baden L, Cheg VCC, et al. Infectious Diseases Society of American Guideline on the Treatment and Management of Patients with Covid-19. IDSA [Internet]. 2020 [citado 13 Abr 2021]; Version 4.2.1. Disponible en: https://www.idsociety.org/globalassets/idsa/practice-guidelines/covid-19/treatment/idsa-covid-19-gl-tx-and-mgmt-v9.0.0.pdf

Frediansyanh A, Nainu F, Dhama K, Mudatsir M, Harapan H. Remdesivir and its antiviral activity against COVID-19: A Systematic Review. Clin. Epidemiology Glob. Health. [Internet]. 2020 [citado 13 Abr 2021];9:123-27. Disponible en: https://www.sciencedirect.com/science/article/pii/S2213398420301810

Humeniuk R, Mathias A, Kirby BJ, Lutz JD, Cao H, Osinusi A, et al. Pharmacokinetic, Pharmacodynamic, and Drugs Interaction Profile of Remdesivir, a SARS-CoV-2 Replication Inhibitor. Clin Pharmacokinet [Internet]. 2021 [citado 13 Abr 2021];60:569-83. Disponible en: https://link.springer.com/content/pdf/10.1007/s40262-021-00984-5.pdf

Sherwat A, Murray J, Birnkrant D, Farley J. Combined Cross-Discipline Team Leader, Division Director and ODE Director Summery Review. Center for Drugs Evaluation and Research. Application Number: 214787rig1s000. Summary Review. Gialead Sciences Inc [Internet]. 21 Oct 2020 [citado 13 Abr 2021]; NDA 214787. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/214787Orig1s000Sumr.pdf

Jaime-Lin HX, Cho S, Meyyur-Aravamudan V, Yu-Sanda H, Palraj R, Molton JS, et al. Remdesivir in Coronavirus Disease 2019 (COVID-19) treatment: a review of evidence. Infection [Internet]. 2020 [citado 13 Abr 2021];49(3):201-10. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778417/pdf/15010_2020_Article_1557.pdf

Killegeros M, Tashima KT, Mylona EK, Rybal N, Flanigan TP, Farmakiotis D, et al. Remdesir Use Compared With Supportive Care in Hospitalized Patients With Severe COVID-19: A single Single-Center Experience. Open Forum Infect Dis [Internet]. 2020 [citado 13 Abr 2021];7(10):[aprox. 8 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454852/pdf/ofaa319.pdf

Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y, et al. Remdesivir in adults with severe Covid-19: a randomised, double blind, placebo-controlled, multicentre trial. Lancet [Internet] 2020 [citado 13 Abr 2021];395:1569-78. Disponible en: http://klinikfarmakoloji.com/sites/default/files/2020-08/remdesivir-wang.pdf

Al-Abdouh A, Bizanti A, Barbarawi M, Jadri A, Kumar A, Fashanu OE, et al. Remdesivir for treatment of Covid-19: A systematic review and meta-analysis of randomized controlled trials. Contemp Clin Trials [Internet]. 2021 [citado 13 Abr 2021];101. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789823/pdf/main.pdf

Kelleni M. Tocilizumab, Remdesivir, Favipiravir, and Dexamethasone Repurposed for Covid-19: a Comprenhensive Clinical and Pharmacovigilant Reassessment. SN Compr Clin Med [Internet]. 2021 [citado 13 Abr 2021];3(4):919-23. Disponible en: https://link.springer.com/content/pdf/10.1007/s42399-021-00824-4.pdf?pdf=button%20sticky

Beigel JH, Tomashek KM, Dodd LE, Metha AK, Zingman BS, Kalil AC, et al. Remdesivir for Treatment of Covid-19- Final Report. N Engl J Med [Internet]. 2020 [citado 13 Abr 2021];383(19):1813-26. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262788/pdf/NEJMoa2007764.pdf

Musa A, Pendi K, Hashemi A, Warbasse E, Kouyoumjian S, Yousif J, et al. Remdesivir for the Treatment of Covid-19: A Systematic Review of the Literature. West J Emerg Med [Internet]. 2020 [citado 13 Abr 2021];21(4):737-41. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7390571/pdf/wjem-21-737.pdf

Spinner CD, Gottlieb RL, Criner GJ, Arribas LJR, Cattelan AM, Viladomiu SA, et al. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderates Covid-19: a Ramdomized Clinical Trial. JAMA [Internet]. 2020 [citado 13 Abr 2021];324(11):1048-57. Disponible en: https://jamanetwork.com/journals/jama/articlepdf/2769871/jama_spinner_2020_oi_200097_1600070022.50408.pdf

Hu WJ, Chang L, Yang Y, Wang X, Xie YC, Shen JS, et al. Pharmacokinetics and tissues Distribuition of remdesivir and its metabolites nucleotide monophosphate, nucleotide triphosphate, and nucleoside in mice. Acta Pharmacol. Sin [Internet]. 2020 [citado 13 Abr 2021];42(7):[aprox. 6 p.]. Disponible en: https://www.researchgate.net/profile/Bo-Tan-14/publication/345365827_Pharmacokinetics_and_tissue_distribution_of_remdesivir_and_its_metabolites_nucleotide_monophosphate_nucleotide_triphosphate_and_nucleoside_in_mice/links/5fd897ca299bf140880f8ea9/Pharmacokinetics-and-tissue-distribution-of-remdesivir-and-its-metabolites-nucleotide-monophosphate-nucleotide-triphosphate-and-nucleoside-in-mice.pdf?origin=publication_detail

Patrick-Lê M, Hingrat-Le Q, Jaquet P, Wicky PH, Bunel V, Massias L, et al. Removal of Remdesivir’s Metabolite GS-441524 by Hemodialysis in Double Lung Transplant Recipient with Covid-19. ASM J [Internet]. 2020 [citado 13 Abr 2021];64(11):e1521-20. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577145/pdf/AAC.01521-20.pdf

Sahakijpijarn S, Moon C, Warnken ZN, Maier EY, DeVore JE, Christensen DJ, et al. In vivo pharmacokinetic study of remdesivir dry powder for inhalation in hamsters. Int. J. Pharm [Internet]. 2021 [citado 13 Abr 2021];3[aprox. 7 p.]. Disponible en: https://www.sciencedirect.com/science/article/pii/S2590156721000025

Goldman JD, Lye DC, Hui DS, Marks KS, Bruno R, Montejano R, et al. Remdesivir for 5 or 10 Days in Patients with Severe Covid-19. N Engl J Med [Internet]. 2020 [citado 13 Abr 2021];383(19):1827-37. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377062/pdf/NEJMoa2015301.pdf

Nies AT, König J, Hofmann U, Kölz C, Fromm MF, Schwab M. Interaction of Remdesivir with Clinically Relevant Hepatic Drugs Uptake Transporter. Pharmaceutics [Internet]. 2021 [citado 13 Abr 2021];13(3):[aprox 8 p.]. Disponible en: https://mdpi-res.com/d_attachment/pharmaceutics/pharmaceutics-13-00369/article_deploy/pharmaceutics-13-00369-v2.pdf?version=1615451326

Peyko V, Ledd H, Cutrona A. The Safety Administration of Remdesivir in a Patient with Acute Kidney Injury Requiring Hemodialysis. Case Rep Infect Dis [Internet]. 2020 [citado 13 Abr 2021]:[aprox. 5 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771254/pdf/CRIID2020-8811798.pdf

Thakare S, Gandhi C, Modi T, Bose S, Deb S, Saxena N, et al. Safety of Remdesivir in Patients With Acute Kidney Injury or CKD. Kidney Int Rep [Internet]. 2020 [citado 13 Abr 2021];6(1):206-10. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547837/pdf/main.pdf

Sörgel F, Malin JJ, Hagmann H, Kinzing M, Bilal M, Eichenauer DA, et al. Pharmacokinetics of remdesivir in a Covid-19 patient with end-stage renal disease on intermittent haemodialysis. J Antimicrob Chemother [Internet]. 2020 [citado 13 Abr 2021];76(3):825-27. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799013/pdf/dkaa500.pdf

Ackley TW, McManus D, Topal JE, Cicali B, Shah S. A Valid Warning or Clinical Lore: an Evaluation of Safety Outcomes of Remdesivir in Patients with Impaired Renal Function from a Multicenter Matched Cohort. Antimicrob. Agents Chemother [Internet]. 2021 [citado 1 May 2021];65(2):[aprox. 9 p.]. Disponible : https://journals.asm.org/doi/epub/10.1128/AAC.02290-20

Adapa S, Chenna A, Balla M, Prasad GM, Koduri NM, Doggubati SR, et al. Covid-19 Pandemia Causing Acute Kidney Injury and Impacto in Patients With Chronic Kidney Diseases and Renal Transplantation. J Clin Med Res [Internet]. 2020 [citado 1 May 2021];12(6):352-61. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295554/pdf/jocmr-12-352.pdf

Xu Z, Tang Y, Huang Q, Fu Sha, Li X, Lin B, et al. Systematic review and subgroup analysis of the incidence of acute kidney injury (AKI) in patients with Covid-19. BMC Nephrol [Internet]. 2021 [citado 1 May 2021];22(1):[aprox. 10 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863041/pdf/12882_2021_Article_2244.pdf

Kalil AC, Patterson ACK, Mehta AK, Tomashek KM, Ghazaryan WV, Marconi VC, et al. Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19. N Engl J Med [Internet]. 2021 [citado 1 May 2021];384(9):795-807. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745180/pdf/NEJMoa2031994.pdf

Ghosh CK, Hasan SMA, Dey S. Remdesivir Induced Liver Injury and Severe Covid-19 Infection. Am. J. Med [Internet]. 2020 [citado 1 May 2021];8(6):285-88. Disponible en: https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20200806.18.pdf

Téllez L, Martín-Mateos RM. Actualización en Covid-19 y enfermedades hepáticas. Gastroenterol

Hepatol [Internet]. 2020 [citado 1 May 2021];43(8):472-80. Disponible en: https://www.elsevier.es/es-revista-gastroenterologia-hepatologia-14-pdf-S0210570520302417

Nardo AD, Gleixner MS, Bakail M, Dixon ED, Lax SF, Trauner M. Phatophysiological Mechanisms of Liver Injury in Covid-19. Liver Int [Internet]. 2020 [citado 1 May 2021];41(1):[aprox 13 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753756/pdf/LIV-9999-na.pdf

Vitiello A, Porta RL, D´Aiuto V, Ferrara F. The risks of liver injury in Covid-19 patients and pharmacological management to reduce or prevent the damage induced. Egypt Liver J [Internet]. 2021 [citado 1 May 2021];11(1):[aprox. 11 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838235/pdf/43066_2021_Article_82.pdf

Jorgensen SCJ, Kebriaei R, Dresser LD. Remdesivir: Review of Pharmacology, Pre-Clinical Data and Emerging Clinical Experience for Covid-19. Pharmacotherapy [Internet]. 2020 [citado 1 May 2021];40(7):659-71. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283864/pdf/PHAR-9999-na.pdf

MohammadReza-Hashemian S, Farhadi T, Akbar AV. A Review on Remdesivir: A Possible Promising Agent for the Treatment of Covid-19. Drug Des Devel Ther [Internet]. 2020 [citado 1 May 2021];2020(14):3215-22. Disponible en: https://www.tandfonline.com/doi/full/10.2147/DDDT.S261154

Descargas

Publicado

05-05-2023

Cómo citar

1.
Arceo Naranjo R, González Blanco I, Díaz Molina M. Valoración del uso del remdesivir para el tratamiento de la COVID-19. Mediciego [Internet]. 5 de mayo de 2023 [citado 27 de julio de 2024];29(1):e3169. Disponible en: https://revmediciego.sld.cu/index.php/mediciego/article/view/3169

Número

Sección

Artículo de revisión