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Potential Role of Anti-interleukin (IL)-6 Drugs in the Treatment of COVID-19: Rationale, Clinical Evidence and Risks.
BioDrugs. 2020 Aug; 34(4):415-422.B

Abstract

The epidemic due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been spreading globally, raising increasing concerns. This public health emergency has triggered a race to find medications to improve the prognosis of this disease. There is currently great interest in drug repositioning to manage SARS-CoV-2 infection, that is, the evaluation of the potential benefits of a drug that has already been proven safe and effective in humans for other approved indications. As interleukin-6 (IL-6) acts as a key driver of the inflammation associated with coronavirus disease 2019 (COVID-19), IL-6 and IL-6 receptor (IL-6R) inhibition appear to be promising targets for the treatment of COVID-19 patients. It is important to critically analyze the available evidence concerning the use of the available anti-IL-6 (siltuximab) and anti-IL-6R (tocilizumab and sarilumab) agents in COVID-19 patients, in terms of both benefit and risk. In this review, the pathogenesis of the cytokine storm induced by COVID-19, the role of IL-6 in this cytokine storm, the rationale for the use of anti-IL-6 agents, and key information on potential benefits and safety monitoring of these biologicals in COVID-19 patients is discussed.

Authors+Show Affiliations

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy.Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy.Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy.Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy.Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy. trifirog@unime.it.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32557214

Citation

Crisafulli, Salvatore, et al. "Potential Role of Anti-interleukin (IL)-6 Drugs in the Treatment of COVID-19: Rationale, Clinical Evidence and Risks." BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy, vol. 34, no. 4, 2020, pp. 415-422.
Crisafulli S, Isgrò V, La Corte L, et al. Potential Role of Anti-interleukin (IL)-6 Drugs in the Treatment of COVID-19: Rationale, Clinical Evidence and Risks. BioDrugs. 2020;34(4):415-422.
Crisafulli, S., Isgrò, V., La Corte, L., Atzeni, F., & Trifirò, G. (2020). Potential Role of Anti-interleukin (IL)-6 Drugs in the Treatment of COVID-19: Rationale, Clinical Evidence and Risks. BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy, 34(4), 415-422. https://doi.org/10.1007/s40259-020-00430-1
Crisafulli S, et al. Potential Role of Anti-interleukin (IL)-6 Drugs in the Treatment of COVID-19: Rationale, Clinical Evidence and Risks. BioDrugs. 2020;34(4):415-422. PubMed PMID: 32557214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potential Role of Anti-interleukin (IL)-6 Drugs in the Treatment of COVID-19: Rationale, Clinical Evidence and Risks. AU - Crisafulli,Salvatore, AU - Isgrò,Valentina, AU - La Corte,Laura, AU - Atzeni,Fabiola, AU - Trifirò,Gianluca, PY - 2020/6/20/pubmed PY - 2020/8/7/medline PY - 2020/6/20/entrez SP - 415 EP - 422 JF - BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy JO - BioDrugs VL - 34 IS - 4 N2 - The epidemic due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been spreading globally, raising increasing concerns. This public health emergency has triggered a race to find medications to improve the prognosis of this disease. There is currently great interest in drug repositioning to manage SARS-CoV-2 infection, that is, the evaluation of the potential benefits of a drug that has already been proven safe and effective in humans for other approved indications. As interleukin-6 (IL-6) acts as a key driver of the inflammation associated with coronavirus disease 2019 (COVID-19), IL-6 and IL-6 receptor (IL-6R) inhibition appear to be promising targets for the treatment of COVID-19 patients. It is important to critically analyze the available evidence concerning the use of the available anti-IL-6 (siltuximab) and anti-IL-6R (tocilizumab and sarilumab) agents in COVID-19 patients, in terms of both benefit and risk. In this review, the pathogenesis of the cytokine storm induced by COVID-19, the role of IL-6 in this cytokine storm, the rationale for the use of anti-IL-6 agents, and key information on potential benefits and safety monitoring of these biologicals in COVID-19 patients is discussed. SN - 1179-190X UR - https://www.unboundmedicine.com/medline/citation/32557214/Potential_Role_of_Anti_interleukin__IL__6_Drugs_in_the_Treatment_of_COVID_19:_Rationale_Clinical_Evidence_and_Risks_ L2 - https://dx.doi.org/10.1007/s40259-020-00430-1 DB - PRIME DP - Unbound Medicine ER -