Severe metabolic accumulation of VV116 in kidney transplant patients with impaired renal function: a case series report

Abstract

The treatment of COVID-19 in the post-transplant individuals is challenging, primarily due to the drug-drug interaction between nirmatrelvir/ritonavir and tacrolimus. Deuremidevir hydrobromide tablets (VV116) is an orally small molecule agents target SARS-CoV-2 RdRp and inhibits viral replication. It may have a low likelihood of drug-drug interactions and has a potential to provide new treatment option. We described three cases of renal transplant patients with concomitant impaired renal function who developed COVID-19 pneumonia and were treated with VV116. Despite varying degrees of drug accumulation, these patients achieved rapid viral clearance and showed prompt improvement in pneumonia symptoms. Notably, tacrolimus blood concentrations remained within the therapeutic range throughout treatment, and no clinically significant adverse events were observed despite the drug accumulation.

Keywords: COVID-19; VV116; drug accumulation; kidney dysfunction; organ transplant.

Figure 1

(A). VV116-N1 concentration, virologic results and medicine administration for case 1, Serial chest imaging by computed tomography (CT), the image on June 7th was from another hospital and taken with a mobile phone camera. (B). VV116-N1 concentration, virologic results and medicine administration for case 2, the Ct. value of N-gene on February 26th was from another hospital, Serial chest imaging by computed tomography (CT), the image was taken on February 27th, March 1st and March 7th. (C). VV116-N1 concentration, virologic results and medicine administration for case 3, the Ct. value of N-gene on April 8th was from another hospital, Serial chest imaging by computed tomography (CT), the image was taken on April 10 th and April 13 th.