Ambrisentan use in a HIV-1 infected patient with end-stage renal disease and pulmonary hypertension

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...

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Detalles Bibliográficos
Autores: Santos, José Ramón|||0000-0002-0886-7114, Merino Ribas, Ana|||0000-0002-8322-4047, Haefeli, Walter E., Miranda, Cristina, Prats, Marisol, Bancu, Ioana|||0000-0002-6799-2169, Bailón, Lucía|||0000-0001-7277-9314, Moltó, José|||0000-0003-4564-1963
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:226224
Acceso en línea:https://ddd.uab.cat/record/226224
https://dx.doi.org/urn:doi:10.1186/s12882-019-1659-5
Access Level:acceso abierto
Palabra clave:Ambrisentan
Hemodialysis
Pulmonary arterial hypertension
HIV-infection
Drug interactions
Descripción
Sumario: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.

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