Therapeutic Drug Monitoring and Dosage Adjustments of Immunosuppressive Drugs When Combined With Nirmatrelvir/Ritonavir in Patients With COVID-19

*Department of Pharmacology, Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET—UMR S 1085, Rennes, France;

†INSERM, Centre d’Investigation Clinique 1414, Rennes, France;

‡Department of Nephrology, Charité Universitätsmedizin Berlin, Berlin, Germany;

§Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, the Netherlands;

¶Department of Pharmacology, Oslo University Hospital and Department of Pharmacy, University of Oslo, Norway;

‖University of Limoges, Inserm U1248, Pharmacology & Transplantation, Limoges, France;

**National Center for Liver Transplantation and Liver Diseases, Army Forces Hospital, Montevideo, Uruguay;

††Department of Pharmaceutical Sciences, School of Pharmacy and Department of Pathology, Starzl Transplantation Institute, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;

‡‡Integrated Pharmacometrics, Pharmacogenetic and Pharmacokinetics Research Group (PMGK), Louvain Drug for Research Institute (LDRI), Catholic University of Louvain (UCLouvain), Brussels, Belgium;

§§Erasmus MC Transplant Institute, University Medical Center, Rotterdam, the Netherlands;

¶¶Department of Drug Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland;

‖‖University of Utah Health Sciences Center and ARUP Laboratories, Salt Lake City, Utah;

***Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands;

†††Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, INDIA;

‡‡‡Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERehd, Spain;

§§§Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, Japan; and

¶¶¶Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

Correspondence: Florian Lemaitre, PharmD, PhD, Department of Pharmacology, Rennes University Hospital, 2 rue Henri Le Guilloux, Rennes 35033, France (e-mail: [email protected]).

F. Lemaitre received research grants from Astellas Pharma, Sandoz ,and Chiesi Pharma (Paid to his institution) and fees to attend meetings from Chiesi Pharma and Sandoz; K. Budde received Honoraria, research grants from Abbvie, Akebia, Alexion, Astellas, Bristol-Myers Squibb, Calliditas, CSL-Behring, Chiesi, Fresenius, Hexal, Hookipa, MSD Sharp & Dohme, Neovii, Novartis, Otsuka, Pfizer, Quark, Sanofi, Shire, UCB Pharma, Veloxis, Vifor, and Vitaeris Pharma; T. Van Gelder received lecture fees and study grants from Chiesi and Astellas, in addition to consulting fees from Roche Diagnostics, Thermo Fisher, Vitaeris, CSL Behring, Astellas, and Aurinia Pharma (all paid to his institution); D. A. Hesselink received lecture fees and consulting fees from Astellas Pharma, Chiesi Pharma, Medincell, Novartis Pharma, Sangamo Therapeutics, and Vifor Pharma. He also received grant support from Astellas Pharma, Bristol-Myers Squibb, and Chiesi Pharma (paid to his institution). S. Masuda received lecture fees from Astellas Pharma, Novartis Pharma, and Otsuka Pharmaceutical Factory. He also received consulting fees from Meiji-Seika Pharma. The remaining authors declare no conflict of interest.

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