Ambrisentan use in a HIV-1 infected patient with end-stage renal disease and pulmonary hypertension : minimal removal by hemodialysis - a case report
Santos, José Ramón (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Merino Ribas, Ana (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Haefeli, Walter E. (Heidelberg University Hospital (Alemanya))
Miranda, Cristina (Institut Germans Trias i Pujol. Fundació de Lluita Contra la Sida)
Prats, Marisol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bancu, Ioana (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bailón, Lucía (Institut Germans Trias i Pujol. Fundació de Lluita Contra la Sida)
Moltó, José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Ambrisentan is a selective endothelin receptor antagonist used for the treatment of pulmonary arterial hypertension (PAH). Little is known about ambrisentan removal by hemodialysis in patients with end-stage renal disease (ESRD). A 53-year-old woman with HIV/hepatitis C virus (HCV) co-infection, PAH and ESRD on regular hemodialyis was admitted in our hospital due to refractory heart failure while on treatment with bosentan (125 mg twice daily) and tadalafil (20 mg once daily) for PAH and antiretroviral treatment (cART) including darunavir/cobicistat (800/150 mg once daily). Excessive exposure to bosentan due to drug interactions between bosentan and darunavir/cobicistat was suspected. Bosentan was replaced by ambrisentan, with progressive improvement in her clinical condition. Pre- and postdialyzer cocentrations of ambrisentan in plasma were determined and hemodialysis extraction ratio for ambrisentan was 2%. Our results suggest that hemodialysis results in minimal ambrisentan removal, and therefore no specific ambrisentan dosage adjustment seems to be required in ESRD patients undergoing hemodialysis.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Ambrisentan ; Hemodialysis ; Pulmonary arterial hypertension ; HIV-infection ; Drug interactions
Published in:	BMC Nephrology, Vol. 21 (january 2020) , ISSN 1471-2369

DOI: 10.1186/s12882-019-1659-5
PMID: 31992232

4 p, 481.9 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles