Najnovejši podatki podpirajo nadaljnjo uporabo zaviralcev angiotenzinske konvertaze (zaviralcev ACE) ter antagonistov angiotenzina II (sartanov) med pandemijo COVID-19

Najnovejši podatki podpirajo nadaljnjo uporabo zaviralcev angiotenzinske konvertaze (zaviralcev ACE) ter antagonistov angiotenzina II (sartanov) med pandemijo COVID-19

Nedavne opazovalne študije z zaviralci angiotenzinske konvertaze (zaviralci ACE) ter antagonisti angiotenzina II (sartani) ne kažejo, da bi ta zdravila vplivala na tveganje za okužbo z novim koronavirusom (virusom, ki povzroča COVID-19) ali imela negativen učinek na izid bolezni pri bolnikih s COVID-19.

Evropska agencija za zdravila (EMA) zato ponovno svetuje, da bolniki nadaljujejo z jemanjem teh zdravil v skladu z navodili zdravnika (glejte objavo JAZMP z dne 30.3.2020). Če imajo vprašanja ali skrbi glede zdravljenja, naj se posvetujejo s svojim zdravnikom.

Zaviralci ACE in sartani se najpogosteje uporabljajo za zdravljenje bolnikov z visokim krvnim tlakom, srčnim popuščanjem in boleznijo ledvic. V medijih in publikacijah je bila izražena zaskrbljenost glede učinkov teh zdravil pri bolnikih s COVID-19. Kot del stalnega spremljanja varnosti zdravil je bilo pregledanih 20 nedavno objavljenih študij o uporabi zaviralcev ACE in sartanov med pandemijo COVID-19, ki so pokazale, da najnovejši klinični dokazi teh pomislekov ne podpirajo.

V okviru EU regulativne mreže o zdravilih bodo EMA in pristojni nacionalni organi držav članic EU še naprej spremljali vse razpoložljive in nove podatke o uporabi zdravil v času pandemije COVID-19 in sodelovali z drugimi regulatorji in zadevnimi evropskimi in mednarodnimi organizacijami, da bi zagotovili zanesljive nasvete za varno uporabo zdravil.  Informacije o priporočilih o COVID-19 so dostopne na spletnih straneh EMA in JAZMP.

Povzeto po objavi EMA skupine COVID-19 EMA pandemic Task Force (COVID-ETF).

V primeru kakršnihkoli novih priporočil bomo javnost sproti obveščali.

Reference

  1. Bean D, Kraljevic Z, Searle T et al. Treatment with ACE-inhibitors is associated with less severe SARS-Covid-19 infection in a multi-site UK acute Hospital Trust. doi: 10.13140/RG.2.2.34883.14889/1.
  2. de Abajo F, Rodríguez-Martín S, Lerma V et al. Use of renin–angiotensin–aldosterone system inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study. doi: 10.1016/S0140-6736(20)31030-8.
  3. Felice C, Nardin C, Di Tanna GL et al. Use of RAAS inhibitors and risk of clinical deterioration in COVID-19: results from an Italian cohort of 133 hypertensives. doi: 10.1093/ajh/hpaa096.
  4. Gao C, Cai Y, Zhang K et al. Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. doi: 10.1093/eurheartj/ehaa433.
  5. Gnavi R, Demaria M, Picariello, R et al. Therapy with agents acting on the renin-angiotensin system and risk of SARS-CoV-2 infection. doi: 10.1093/cid/ciaa634.
  6. Guo T, Fan Y, Chen M et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). doi: 10.1001/jamacardio.2020.1017.
  7. Jung S-Y, Choi JC, You S-H et al. Association of renin-angiotensin-aldosterone system inhibitors with COVID-19-related outcomes in Korea: a nationwide population-based cohort study.  doi: 10.1093/cid/ciaa624/5842160.
  8. Li J, Wang X, Chen J et al. Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China. doi: 10.1001/jamacardio.2020.1624.
  9. Mancia G, Rea F, Ludergnani M et al. Renin–Angiotensin–Aldosterone System Blockers and the Risk of Covid-19. doi: 10.1056/NEJMoa2006923.
  10. Mehra MR, Desai SS, Kuy S, et al. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. doi: 10.1056/NEJMoa2007621. The publication of this study was subsequently retracted by the authors. doi: 10.1056/NEJMc2021225. The retraction has no impact on this public statement as the study did not influence the conclusions.
  11. Mehta N, Kalra A, Nowacki AS et al. Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Testing Positive for Coronavirus Disease 2019 (COVID-19). doi: 10.1001/jamacardio.2020.1855.
  12. Meng, J, Xiao G, Zhang J et al. Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension. doi: 10.1080/22221751.2020.1746200.
  13. Rentsch CT, Kidwai-Khan F, Tate, JP et al. Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54-75 Years. doi: 10.1101/2020.04.09.20059964.
  14. Reynolds HR, Adhikari S, Pulgarin C et al. Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19. doi: 10.1056/NEJMoa2008975.
  15. Richardson S, Hirsch JS, Narasimhan M et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. doi: 10.1001/jama.2020.6775.
  16. Rossi GP, Marino M, Formisano D et al. Characteristics and outcomes of a cohort of SARS-CoV-2 patients in the province of Reggio Emilia, Italy. doi: 10.1101/2020.04.13.20063545.
  17. Tedeschi S, Giannella M, Bartoletti M et al. Clinical impact of renin-angiotensin system inhibitors on in-hospital mortality of patients with hypertension hospitalized for COVID-19. doi: 10.1093/cid/ciaa492.
  18. Yang G, Tan Z, Zhou L et al. Angiotensin II Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors Usage is Associated with Improved Inflammatory Status and Clinical Outcomes in COVID-19 Patients With Hypertension. doi: 10.1101/2020.03.31.20038935.
  19. Zeng Z, Sha T, Zhang Y, et al. Hypertension in patients hospitalized with COVID-19 in Wuhan, China: a single-center retrospective observational study. doi: 10.1101/2020.04.06.20054825.
  20. Zhang P, Zhu L, Cai J et al. Association of Inpatient Use of Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Mortality Among Patients With Hypertension Hospitalized With COVID-19. doi: 10.1161/CIRCRESAHA.120.317134.
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