Prolonged Exposure to Remdesivir Inhibits the Human Ether-A-Go-Go-Related Gene Potassium Current

J Cardiovasc Pharmacol. 2023 Sep 1;82(3):212-220. doi: 10.1097/FJC.0000000000001449.

Abstract

Remdesivir, approved for the treatment of COVID-19, has been associated with heart-rate corrected QT interval (QTc) prolongation and torsade de pointes in case reports. However, data are conflicting regarding the ability of remdesivir to inhibit the human ether-a-go-go-related gene (hERG) -related current. The objective of this study was to investigate the effects remdesivir and its primary metabolite, GS-441524, on hERG-related currents. Human embryonic kidney 293 cells stably expressing hERG were treated with various concentrations of remdesivir and GS-441524. The effects of acute and prolonged exposure on hERG-related current were assessed using whole-cell configuration of voltage-clamp protocols. Acute exposure to remdesivir and GS-441524 had no effect on hERG currents and the half-activation voltage (V 1/2 ). Prolonged treatment with 100 nM and 1 µM remdesivir significantly reduced peak tail currents and hERG current density. The propensity for remdesivir to prolong QTc intervals and induce torsade de pointes in predisposed patients warrants further investigation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19 Drug Treatment
  • COVID-19*
  • Ether-A-Go-Go Potassium Channels / genetics
  • Ethers
  • Humans
  • Potassium
  • Potassium Channel Blockers / pharmacology
  • Torsades de Pointes*

Substances

  • Ether-A-Go-Go Potassium Channels
  • remdesivir
  • Potassium
  • Ethers
  • Potassium Channel Blockers