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IL-6 Inhibitors in the Treatment of Serious COVID-19: A Promising Therapy?
Atal, Shubham; Fatima, Zeenat.
  • Atal S; Department of Pharmacology, 3rd Floor, AIIMS Bhopal, AIIMS Medical College Building, Saket Nagar, Bhopal, 462020, India. shubham.pharm@aiimsbhopal.edu.in.
  • Fatima Z; Department of Pharmacology, 3rd Floor, AIIMS Bhopal, AIIMS Medical College Building, Saket Nagar, Bhopal, 462020, India.
Pharmaceut Med ; 34(4): 223-231, 2020 08.
Article in English | MEDLINE | ID: covidwho-597467
Semantic information from SemMedBD (by NLM)
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cytokine
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tocilizumab
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cytokine
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siltuximab
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cytokine
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sarilumab
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8. interleukin-6 PART_OF Lung
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interleukin-6
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9. Signal Transduction Pathways CAUSES Cell Proliferation
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tocilizumab
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cytokine
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siltuximab
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cytokine
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sarilumab
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cytokine
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ABSTRACT
At present, there are no proven agents for treatment of coronavirus disease (COVID-19). The available evidence has not allowed guidelines to clearly recommend any drugs outside the context of clinical trials. The novel coronavirus SARS-CoV-2 that causes COVID-19 invokes a hyperinflammatory state driven by multiple cells and mediators like interleukin (IL)-1, IL-6, IL-12, and IL-18, tumor necrosis factor alpha (TNFα), etc. Considering the proven role of cytokine dysregulation in causing this hyperinflammation in the lungs with IL-6 being a key driver, particularly in seriously ill COVID-19 patients, it is crucial to further explore selective cytokine blockade with drugs like the IL-6 inhibitors tocilizumab, sarilumab, and siltuximab. These targeted monoclonal antibodies can dampen the downstream IL-6 signaling pathways, which can lead to decreased cell proliferation, differentiation, oxidative stress, exudation, and improve clinical outcomes in patients with evident features of cytokine-driven inflammation like persistent fever, dyspnea and elevated markers. Preliminary evidence has come for tocilizumab from some small studies, and interim analysis of a randomized controlled trial; the latter also being available for sarilumab. International guidelines do include IL-6 inhibitors as one of the options available for severe or critically ill patients. There has been increased interest in evaluating these drugs with a series of clinical trials being registered and conducted in different countries. The level of investigation though perhaps needs to be further intensified as there is a need to focus on therapeutic options that can prove to be 'life-saving' as the number of COVID-19 fatalities worldwide keeps increasing alarmingly. IL-6 inhibitors could be one such treatment option, with generation of more evidence and completion of a larger number of systematic studies.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Interleukin-6 / Coronavirus Infections Type of study: Controlled clinical trial / Clinical Practice Guide / Randomized controlled trials Limits: Animals / Humans Language: English Journal: Pharmaceut Med Year: 2020 Document Type: Article Affiliation country: S40290-020-00342-z

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Interleukin-6 / Coronavirus Infections Type of study: Controlled clinical trial / Clinical Practice Guide / Randomized controlled trials Limits: Animals / Humans Language: English Journal: Pharmaceut Med Year: 2020 Document Type: Article Affiliation country: S40290-020-00342-z