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  • Severe rhabdomyolysis and acute asymptomatic pancreatitis following the concomitant use of Biktarvy in the setting of hyperosmolar diabetic crisis

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Unexpected outcome (positive or negative) including adverse drug reactions
Case report
Severe rhabdomyolysis and acute asymptomatic pancreatitis following the concomitant use of Biktarvy in the setting of hyperosmolar diabetic crisis
  1. Sylvain Raoul Simeni Njonnou1,2,
  2. Sophie Henrard2,3,
  3. Lamya Noure2,3 and
  4. Jean-Christophe Goffard2,3
  1. 1Département de Médecine Interne, Faculté de Médecine et des Sciences Pharmaceutiques, Université de Dschang, Dschang, Cameroon
  2. 2Department of Internal Medicine, HIV Reference Center, Hôpital Erasme, Université Libre de Bruxelles, Hopital Erasme, Bruxelles, Belgium
  3. 3Department of Endocrinology, Hôpital Erasme, Université Libre de Bruxelles, Hopital Erasme, Bruxelles, Belgium
  1. Correspondence to Dr Sylvain Raoul Simeni Njonnou; raoulsims{at}yahoo.fr

Abstract

Biktarvy (bictegravir/emtricitabine/tenofovir alafemanide), which has been recently approved for the treatment of HIV, is a single-pill regimen that associates bictegravir and a novel integrase strand transfer inhibitor (INSTI) with a combination of two nucleoside reverse transcriptase inhibitors (NRTI) of emtricitabine and tenofovir alafemanide. Among treatment complications, rhabdomyolysis has been reported in association with some NRTI and INSTI but never with bictegravir. Acute pancreatitis has also been reported recently with another INSTI, dolutegravir. We report here a 62-year-old man with diabetes and HIV infection, and receiving Biktarvy for 1 month. He presented to the emergency department for muscular pain and fatigue. He was on treatment with Descovy (tenofovir alafenamide/emtricitabine) and Viramune (nevirapine) for 2 years but he recently asked for a regimen simplification. Severe rhabdomyolysis and acute pancreatitis were diagnosed. Although the aetiology of these events could be multifactorial, it cannot be ruled out that this episode could be linked to a potential side effect of bictegravir.

  • drug interactions
  • musculoskeletal and joint disorders
  • diabetes
  • pancreatitis
  • HIV / AIDS

https://doi.org/10.1136/bcr-2020-234483

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    Footnotes

    • Contributors Conception and design; data collection; data analysis and interpretation; reviewing manuscript: SRSN, SH, LN, J-CG. All the authors read and approved the final draft for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.