tetano
Editor, Senior Moderator
Liver Int
. 2020 May 17.
doi: 10.1111/liv.14516. Online ahead of print.
First Case of Drug-Induced Liver Injury Associated With the Use of Tocilizumab in a Patient With COVID-19
Damir Muhović[SUP] 1 2 [/SUP], Jelena Bojović[SUP] 3 [/SUP], Ana Bulatović[SUP] 4 [/SUP], Batrić Vukčević[SUP] 1 [/SUP], Marina Ratković[SUP] 1 [/SUP], Ranko Lazović[SUP] 1 [/SUP], Brigita Smolović[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background and aims: Tocilizumab (TCZ; interleukine-6 receptor antagonist) has been proposed to treat severe forms of Coronavirus disease-19 (COVID-19) because interleukine-6 plays an important role in COVID-19-induced cytokine storm. Several clinical studies have shown very good effects of TCZ in patients with COVID-19, with a few minor side effects reported. Only eight serious liver injuries caused by TCZ were reported before being used in the treatment of patients with COVID-19. Considering the significantly increased use of TCZ for the treatment of COVID-19, we would like to warn of its rare but possible serious hepatotoxicity, especially when used together with other hepatotoxic drugs.
Methods: We describe a patient with COVID-19-induced cytokine storm who developed drug-induced liver injury associated with the use of TCZ.
Results: One day after TCZ administration, serum transaminase levels increased 40-fold. Nevertheless, TCZ had a positive effect on clinical and laboratory parameters in cytokine storm, with transaminases values normalizing in 10 days.
Conclusions: This is the first reported case of DILI caused by TCZ in a COVID-19 patient. Intensive liver function monitoring is imperative in COVID-19 patients, because of frequent polypharmacy with potentially hepatotoxic drugs.
Keywords: COVID-19; SARS-CoV-2; drug-induced liver injury; hepatotoxicity; tocilizumab.
. 2020 May 17.
doi: 10.1111/liv.14516. Online ahead of print.
First Case of Drug-Induced Liver Injury Associated With the Use of Tocilizumab in a Patient With COVID-19
Damir Muhović[SUP] 1 2 [/SUP], Jelena Bojović[SUP] 3 [/SUP], Ana Bulatović[SUP] 4 [/SUP], Batrić Vukčević[SUP] 1 [/SUP], Marina Ratković[SUP] 1 [/SUP], Ranko Lazović[SUP] 1 [/SUP], Brigita Smolović[SUP] 1 2 [/SUP]
Affiliations
- PMID: 32478465
- DOI: 10.1111/liv.14516
Abstract
Background and aims: Tocilizumab (TCZ; interleukine-6 receptor antagonist) has been proposed to treat severe forms of Coronavirus disease-19 (COVID-19) because interleukine-6 plays an important role in COVID-19-induced cytokine storm. Several clinical studies have shown very good effects of TCZ in patients with COVID-19, with a few minor side effects reported. Only eight serious liver injuries caused by TCZ were reported before being used in the treatment of patients with COVID-19. Considering the significantly increased use of TCZ for the treatment of COVID-19, we would like to warn of its rare but possible serious hepatotoxicity, especially when used together with other hepatotoxic drugs.
Methods: We describe a patient with COVID-19-induced cytokine storm who developed drug-induced liver injury associated with the use of TCZ.
Results: One day after TCZ administration, serum transaminase levels increased 40-fold. Nevertheless, TCZ had a positive effect on clinical and laboratory parameters in cytokine storm, with transaminases values normalizing in 10 days.
Conclusions: This is the first reported case of DILI caused by TCZ in a COVID-19 patient. Intensive liver function monitoring is imperative in COVID-19 patients, because of frequent polypharmacy with potentially hepatotoxic drugs.
Keywords: COVID-19; SARS-CoV-2; drug-induced liver injury; hepatotoxicity; tocilizumab.