TY - JOUR
T1 - Prophylactic and early outpatient treatment of COVID-19 in patients with kidney disease
T2 - considerations from the Immunonephrology Working Group of the European Renal Association (ERA-IWG)
AU - Hilhorst, Marc
AU - Bemelman, Frederike J.
AU - Bruchfeld, Annette
AU - Fernandez-Juarez, Gema M.
AU - Floege, J. rgen
AU - Frangou, Eleni
AU - Goumenos, Dimitrios
AU - van Kooten, Cees
AU - Kronbichler, Andreas
AU - Stevens, Kate I.
AU - Turkmen, Kultigin
AU - Wiersinga, W. Joost
AU - Anders, Hans-Joachim
N1 - Funding Information: M.H. received speaker fees from AstraZeneca and consulting honoraria from CSL Vifor. W.J.W. reported receiving grant support (grant 91 716 475) from the Netherlands Organization of Scientific Research and consulting honoraria paid to his institution from GlaxoSmithKline, Pfizer, Sobi and AstraZeneca. K.I.S. has received honoraria for consulting from Boehringer Ingelheim and speaker fees from Bayer Pharmaceuticals. A.K. received honoraria for consulting from Alexion, Otsuka, Catalyst Biosciences, UriSalt, Vifor Pharma and Delta 4, and speaking fees from Vifor Pharma and Otsuka. A.B. has received honoraria and lecture fees from AstraZeneca, Bayer, ChemoCentryx, Fresenius, Merck/MSD and Vifor. J.F. has received honoraria or lecture fees from AstraZeneca, Bayer, Boehringer, Calliditas/Stadapharm, Novartis, Omeros, Travere and Vifor, and serves on data safety monitoring boards of NovoNordisk and Visterra. H.-J.A. received honoraria or lecture fees from AstraZeneca, Bayer, Eleva, GSK, Kezar, Lilly, Novartis, Otsuka, Previpharma and Vifor. The authors declare no financial or non-financial potential conflicts of interest related to this project. Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the ERA.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic led to rapid vaccine development and large global vaccination schemes. However, patients with immune-mediated kidney disease, chronic kidney diseases and kidney transplant recipients show high non-response rates to vaccination despite more than three vaccinations and, consequently, reduced viral clearance capacity when infected while receiving certain immunosuppressants, carrying an elevated risk for coronavirus disease 2019 (COVID-19)-related morbidity and mortality. SARS-CoV-2 evolution has been characterized by the emergence of novel variants and spike mutations contributing to waning efficacy of neutralizing antibodies. To this end, the therapeutic field expands from vaccination towards a combined approach of immunization, pre-exposure prophylaxis and early post-exposure treatment using direct-acting antivirals and neutralizing monoclonal antibodies to treat early in the disease course and avoid hospitalization. This expert opinion paper from the Immunonephrology Working Group of the European Renal Association (ERA-IWG) summarizes available prophylactic and/or early treatment options (i.e. neutralizing monoclonal antibodies and direct-acting antivirals) of SARS-CoV-2-infected patients with immune-mediated kidney disease, chronic kidney disease and kidney transplant recipients.
AB - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic led to rapid vaccine development and large global vaccination schemes. However, patients with immune-mediated kidney disease, chronic kidney diseases and kidney transplant recipients show high non-response rates to vaccination despite more than three vaccinations and, consequently, reduced viral clearance capacity when infected while receiving certain immunosuppressants, carrying an elevated risk for coronavirus disease 2019 (COVID-19)-related morbidity and mortality. SARS-CoV-2 evolution has been characterized by the emergence of novel variants and spike mutations contributing to waning efficacy of neutralizing antibodies. To this end, the therapeutic field expands from vaccination towards a combined approach of immunization, pre-exposure prophylaxis and early post-exposure treatment using direct-acting antivirals and neutralizing monoclonal antibodies to treat early in the disease course and avoid hospitalization. This expert opinion paper from the Immunonephrology Working Group of the European Renal Association (ERA-IWG) summarizes available prophylactic and/or early treatment options (i.e. neutralizing monoclonal antibodies and direct-acting antivirals) of SARS-CoV-2-infected patients with immune-mediated kidney disease, chronic kidney disease and kidney transplant recipients.
KW - COVID-19
KW - antiviral therapy
KW - kidney
KW - prophylaxis
KW - transplantation
UR - http://www.scopus.com/inward/record.url?scp=85164575081&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ndt/gfad044
DO - https://doi.org/10.1093/ndt/gfad044
M3 - Article
C2 - 36881727
SN - 0931-0509
VL - 38
SP - 1807
EP - 1816
JO - Nephrology dialysis transplantation
JF - Nephrology dialysis transplantation
IS - 8
ER -