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10.1016/j.ijcard.2020.10.028

http://scihub22266oqcxt.onion/10.1016/j.ijcard.2020.10.028
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suck abstract from ncbi


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pmid33075384      Int+J+Cardiol 2021 ; 324 (ä): 255-260
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  • Spontaneous reported cardiotoxicity induced by lopinavir/ritonavir in COVID-19 An alleged past-resolved problem #MMPMID33075384
  • Fresse A; Viard D; Romani S; Gerard A; Lepelley M; Rocher F; Salem JE; Drici MD
  • Int J Cardiol 2021[Feb]; 324 (ä): 255-260 PMID33075384show ga
  • The antiretroviral drug lopinavir/ritonavir has been recently repurposed for the treatment of COVID-19. Its empirical use has been associated with multiple cardiac adverse reactions pertaining to its ancillary multi-channel blocking properties, vaguely characterized until now. We aimed to characterize qualitatively the cardiotoxicity associated with lopinavir/ritonavir in the setting of COVID-19. Spontaneous notifications of cardiac adverse drug reactions reported to the national Pharmacovigilance Network were collected for 8 weeks since March 1st 2020. The Nice Regional Center of Pharmacovigilance, whose scope of expertise is drug-induced long QT syndrome, analyzed the cases, including the reassessment of all available ECGs. QTc >/= 500 ms and delta QTc > 60 ms from baseline were deemed serious. Twenty-two cases presented with 28 cardiac adverse reactions associated with the empirical use of lopinavir/ritonavir in a hospital setting. Most adverse reactions reflected lopinavir/ritonavir potency to block voltage-gated potassium channels with 5 ventricular arrhythmias and 17 QTc prolongations. An average QTc augmentation of 97 +/- 69 ms was reported. Twelve QTc prolongations were deemed serious. Other cases were likely related to lopinavir/ritonavir potency to block sodium channels: 1 case of bundle branch block and 5 recurrent bradycardias. The incidence of cardiac adverse reactions of lopinavir/ritonavir was estimated between 0.3% and 0.4%. These cardiac adverse drug reactions offer a new insight in its ancillary multi-channel blocking functions. Lopinavir/ritonavir cardiotoxicity may be of concern for its empirical use during the COVID-19 pandemic. Caution should be exerted relative to this risk where lopinavir/ritonavir summary of product characteristics should be implemented accordingly.
  • |*COVID-19 Drug Treatment[MESH]
  • |*Pharmacovigilance[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |COVID-19/diagnosis/*epidemiology[MESH]
  • |Cardiotoxicity/diagnosis/*epidemiology[MESH]
  • |Drug Combinations[MESH]
  • |Electrocardiography/drug effects/trends[MESH]
  • |Female[MESH]
  • |France/epidemiology[MESH]
  • |HIV Protease Inhibitors/administration & dosage/adverse effects[MESH]
  • |Humans[MESH]
  • |Long QT Syndrome/chemically induced/diagnosis/epidemiology[MESH]
  • |Lopinavir/*administration & dosage/*adverse effects[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Potassium Channel Blockers/administration & dosage/adverse effects[MESH]


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