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Anti-cytokine treatments in Covid-19 disease: IL-6 receptor inhibitor (Tocilizumab) and IL-1 receptor antagonist (Anakinra)

Year 2021, Volume: 28 Issue: COVİD-19 ÖZEL SAYI, 163 - 166, 01.05.2021
https://doi.org/10.17343/sdutfd.897658

Abstract

Coronavirus disease 2019 (COVID-19) first appeared in Wuhan, China in December 2019 and has caused a massive global pandemic. It has become an important problem for public health all over the world. Although the majority of those who suffer from the disease have a good prognosis, it causes macrophage activation syndrome (MAS) that affects the lung in some patients. It is known that the rate of cytokine increase and the amount of cytokines play a role in the transition from the expected inflammation response to hyperinflammation in individuals with the disease. Mortality rates are high in the patient group with MAS, and changes in the clinical and laboratory findings of the patient are observed in a short time. Therefore, a dynamic treatment process is needed. Glucocorticoid treatments are recommended, especially in patients who need respiratory support. Anti-cytokine treatments come into question in patients with no glucocorticoid response. It is important to identify the patient group who can benefit from anti-cytokine therapies correctly and on time, in order to plan an effective and safe treatment.

References

  • 1. Lai C.-C, Shih T.-P, Ko W.-C, Tang H.-J, Hsueh P.-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020;55(3):105924.
  • 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London England) 2020;395(10223):497–506.
  • 3. Siddiqi H.K, Mehra M.R. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. J. Heart Lung Transplant. 2020;39(5):405-7.
  • 4. Fei Zhou, Ting Yu, Ronghui Du, Guohui Fan, Ying Liu, Zhibo Liu, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054-62.
  • 5. Ouédraogo DD, Tiendrébéogo WJS, Kaboré F, Ntsiba H. COVID-19, chronic inflammatory rheumatic disease and anti-rheumatic treatments. Clin Rheumatol. 2020;39(7):2069-75.
  • 6. Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020;39(7):2085-94.
  • 7. Bilimsel Danışma Kurulu Çalışması T.C. Sağlık Bakanlığı, COVID-19 (SARS-CoV-2 enfeksiyonu) Anti sitokin- Antiinflamatuar tedaviler, koagulopati yönetimi. 7 Kasım 2020.
  • 8. Okuda Y. Review of tocilizumab in the treatment of rheumatoid arthritis. Biologics 2008; 2:75.
  • 9. Scott L. Tocilizumab: A Review in Rheumatoid Arthritis. Drugs 2017;77:1865-79.
  • 10. Sheppard M, Laskou F, Stapleton PP, Hadavi S, Dasgupta B. Tocilizumab (Actemra). Hum Vaccin Immunother. 2017;13(9):1972-88.
  • 11. Maus M, Levine B. Chimeric Antigen Receptor T-Cell Therapy for the Community Oncologist. Oncologist 2016;21(5):608-17.
  • 12. Xu X, Han M, Li T, Sun W, Wang D, Fu B, et al. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A. 2020;117(20):10970-5.
  • 13. Lan SH, Lai CC, Huang HT, Chang SP, Lu LC, Hsueh PR. Tocilizumab for severe COVID-19: a systematic review and meta-analysis. Int J Antimicrob Agents 2020;56(3):106103.
  • 14. Hariyanto TI, Hardyson W, Kurniawan A. Efficacy and Safety of Tocilizumab for Coronavirus Disease 2019 (Covid-19) Patients: A Systematic Review and Meta-analysis. Drug Res (Stuttg). 2021 Jan 5. doi: 10.1055/a-1336-2371.
  • 15. Tleyjeh IM, Kashour Z, Damlaj M, Riaz M, Tlayjeh H, Altannir M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(2):215-27.
  • 16. Boregowda U, Perisetti A, Nanjappa A, Gajendran M, Sridharan G, Goyal H. Addition of Tocilizumab to the Standard of Care Reduces Mortality in Severe COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2020;7:586221.
  • 17. Zhao J, Cui W, Tian BP. Efficacy of tocilizumab treatment in severely ill COVID-19 patients. Crit Care 2020;24(1):524.
  • 18. Kotak S, Khatri M, Malik M, Malik M, Hassan W, Amjad A, et al. Use of Tocilizumab in COVID-19: A Systematic Review and Meta-Analysis of Current Evidence. Cureus. 2020;12(10):e10869.
  • 19. Mojtabavi H, Saghazadeh A, Rezaei N. Interleukin-6 and severe COVID-19: a systematic review and meta-analysis. Eur Cytokine Netw 2020;31(2):44-9.
  • 20. Stone JH, Frigault MJ, Serling-Boyd NJ, Fernandes AD, Harvey L, Foulkes AS, et al. Efficacy of Tocilizumab in Patients Hospitalized with Covid-19. N Engl J Med. 2020;383(24):2333-44.
  • 21. Leaf DE, Gupta S, Wang W. Tocilizumab in Covid-19. N Engl J Med. 2021;384(1):86-7.
  • 22. Gupta S, Wang W, Hayek SS, Chan L, Mathews KS, Melamed ML, et al. Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19. JAMA Intern Med. 2021;181(1):41-51.
  • 23. Salama C, Han J, Yau L, Reiss WG, Kramer B, Neidhart JD, et al. Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia. N Engl J Med. 2021;384(1):20-30.
  • 24. Anakinra. US Food and Drug Administration (FDA) approved product information. Revised December 2012. US FDA.
  • 25. Shakoory B, Carcillo JA, Chatham WW, Amdur RL, Zhao H, Dinarello CA, et al. Interleukin-1 Receptor Blockade Is Associated With Reduced Mortality in Sepsis Patients With Features of Macrophage Activation Syndrome: Reanalysis of a Prior Phase III Trial. Crit Care Med. 2016;44(2):275-81.
  • 26. Huet T, Beaussier H, Voisin O, Jouveshomme S, Dauriat G, Lazareth I, et al. Anakinra for severe forms of COVID-19: a cohort study. Lancet Rheumatol. 2020;2(7):393-400.
  • 27. Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020;2(6):325-31.
  • 28. CORIMUNO-19 Collaborative group. Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. Lancet Respir Med. 2021;9(3):295-304.
  • 29. Webb BJ, Peltan ID, Jensen P, Hoda D, Hunter B, Silver A, et al. Clinical criteria for COVID-19-associated hyperinflammatory syndrome: a cohort study. Lancet Rheumatol. 2020;2(12):754-63.
  • 30. Caricchio R, Gallucci M, Dass C, Zhang X, Gallucci S, Fleece D, et al. Preliminary predictive criteria for COVID-19 cytokine storm. Ann Rheum Dis. 2021;80(1):88-95.

Covid-19 Hastalığında Anti-sitokin Tedaviler: IL-6 Reseptör İnhibitörü (Tosilizumab) ve IL-1 Reseptör Antagonisti (Anakinra)

Year 2021, Volume: 28 Issue: COVİD-19 ÖZEL SAYI, 163 - 166, 01.05.2021
https://doi.org/10.17343/sdutfd.897658

Abstract

Koronavirüs hastalığı 2019 (COVID-19) ilk kez Aralık 2019 tarihinde Çin'in Wuhan kentinde ortaya çıktı ve büyük bir küresel salgına neden oldu. Tüm dünyada halk sağlığı için önemli bir problem haline geldi. Hastalık geçirenlerin büyük çoğunluğu iyi bir prognoza sahip olmasına rağmen bazı hastalarda özellikle akciğeri etkileyen makrofaj aktivasyonu sendromuna (MAS) neden olmaktadır. Hastalığı geçiren bireylerde beklenen inflamasyon yanıtından hiperinflamasyona geçişte sitokin artış hızı ve sitokin miktarının rolü olduğu bilinmektedir. MAS gelişen hasta grubunda mortalite oranları yüksek seyretmektedir ve hastaların klinik ve laboratuvar bulgularında kısa sürede ortaya çıkan değişiklikler görülmektedir. Bu nedenle dinamik bir tedavi süreci ihtiyacı vardır. Özellikle solunum desteği ihtiyacı olan hastalarda glukokortikoid tedaviler önerilmektedir. Glukokortikoid yanıtı olmayan hastalarda anti-sitokin tedaviler gündeme gelmektedir. Anti-sitokin tedavilerden yararlanabilecek hasta grubunun doğru ve vaktinde tanımlanması, etkili ve güvenli bir tedavi planlanması açısından önem taşımaktadır.

References

  • 1. Lai C.-C, Shih T.-P, Ko W.-C, Tang H.-J, Hsueh P.-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020;55(3):105924.
  • 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London England) 2020;395(10223):497–506.
  • 3. Siddiqi H.K, Mehra M.R. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. J. Heart Lung Transplant. 2020;39(5):405-7.
  • 4. Fei Zhou, Ting Yu, Ronghui Du, Guohui Fan, Ying Liu, Zhibo Liu, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054-62.
  • 5. Ouédraogo DD, Tiendrébéogo WJS, Kaboré F, Ntsiba H. COVID-19, chronic inflammatory rheumatic disease and anti-rheumatic treatments. Clin Rheumatol. 2020;39(7):2069-75.
  • 6. Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020;39(7):2085-94.
  • 7. Bilimsel Danışma Kurulu Çalışması T.C. Sağlık Bakanlığı, COVID-19 (SARS-CoV-2 enfeksiyonu) Anti sitokin- Antiinflamatuar tedaviler, koagulopati yönetimi. 7 Kasım 2020.
  • 8. Okuda Y. Review of tocilizumab in the treatment of rheumatoid arthritis. Biologics 2008; 2:75.
  • 9. Scott L. Tocilizumab: A Review in Rheumatoid Arthritis. Drugs 2017;77:1865-79.
  • 10. Sheppard M, Laskou F, Stapleton PP, Hadavi S, Dasgupta B. Tocilizumab (Actemra). Hum Vaccin Immunother. 2017;13(9):1972-88.
  • 11. Maus M, Levine B. Chimeric Antigen Receptor T-Cell Therapy for the Community Oncologist. Oncologist 2016;21(5):608-17.
  • 12. Xu X, Han M, Li T, Sun W, Wang D, Fu B, et al. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A. 2020;117(20):10970-5.
  • 13. Lan SH, Lai CC, Huang HT, Chang SP, Lu LC, Hsueh PR. Tocilizumab for severe COVID-19: a systematic review and meta-analysis. Int J Antimicrob Agents 2020;56(3):106103.
  • 14. Hariyanto TI, Hardyson W, Kurniawan A. Efficacy and Safety of Tocilizumab for Coronavirus Disease 2019 (Covid-19) Patients: A Systematic Review and Meta-analysis. Drug Res (Stuttg). 2021 Jan 5. doi: 10.1055/a-1336-2371.
  • 15. Tleyjeh IM, Kashour Z, Damlaj M, Riaz M, Tlayjeh H, Altannir M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(2):215-27.
  • 16. Boregowda U, Perisetti A, Nanjappa A, Gajendran M, Sridharan G, Goyal H. Addition of Tocilizumab to the Standard of Care Reduces Mortality in Severe COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2020;7:586221.
  • 17. Zhao J, Cui W, Tian BP. Efficacy of tocilizumab treatment in severely ill COVID-19 patients. Crit Care 2020;24(1):524.
  • 18. Kotak S, Khatri M, Malik M, Malik M, Hassan W, Amjad A, et al. Use of Tocilizumab in COVID-19: A Systematic Review and Meta-Analysis of Current Evidence. Cureus. 2020;12(10):e10869.
  • 19. Mojtabavi H, Saghazadeh A, Rezaei N. Interleukin-6 and severe COVID-19: a systematic review and meta-analysis. Eur Cytokine Netw 2020;31(2):44-9.
  • 20. Stone JH, Frigault MJ, Serling-Boyd NJ, Fernandes AD, Harvey L, Foulkes AS, et al. Efficacy of Tocilizumab in Patients Hospitalized with Covid-19. N Engl J Med. 2020;383(24):2333-44.
  • 21. Leaf DE, Gupta S, Wang W. Tocilizumab in Covid-19. N Engl J Med. 2021;384(1):86-7.
  • 22. Gupta S, Wang W, Hayek SS, Chan L, Mathews KS, Melamed ML, et al. Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19. JAMA Intern Med. 2021;181(1):41-51.
  • 23. Salama C, Han J, Yau L, Reiss WG, Kramer B, Neidhart JD, et al. Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia. N Engl J Med. 2021;384(1):20-30.
  • 24. Anakinra. US Food and Drug Administration (FDA) approved product information. Revised December 2012. US FDA.
  • 25. Shakoory B, Carcillo JA, Chatham WW, Amdur RL, Zhao H, Dinarello CA, et al. Interleukin-1 Receptor Blockade Is Associated With Reduced Mortality in Sepsis Patients With Features of Macrophage Activation Syndrome: Reanalysis of a Prior Phase III Trial. Crit Care Med. 2016;44(2):275-81.
  • 26. Huet T, Beaussier H, Voisin O, Jouveshomme S, Dauriat G, Lazareth I, et al. Anakinra for severe forms of COVID-19: a cohort study. Lancet Rheumatol. 2020;2(7):393-400.
  • 27. Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020;2(6):325-31.
  • 28. CORIMUNO-19 Collaborative group. Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. Lancet Respir Med. 2021;9(3):295-304.
  • 29. Webb BJ, Peltan ID, Jensen P, Hoda D, Hunter B, Silver A, et al. Clinical criteria for COVID-19-associated hyperinflammatory syndrome: a cohort study. Lancet Rheumatol. 2020;2(12):754-63.
  • 30. Caricchio R, Gallucci M, Dass C, Zhang X, Gallucci S, Fleece D, et al. Preliminary predictive criteria for COVID-19 cytokine storm. Ann Rheum Dis. 2021;80(1):88-95.
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Reviews
Authors

Atalay Doğru 0000-0002-9797-1182

Publication Date May 1, 2021
Submission Date March 23, 2021
Acceptance Date April 15, 2021
Published in Issue Year 2021 Volume: 28 Issue: COVİD-19 ÖZEL SAYI

Cite

Vancouver Doğru A. Covid-19 Hastalığında Anti-sitokin Tedaviler: IL-6 Reseptör İnhibitörü (Tosilizumab) ve IL-1 Reseptör Antagonisti (Anakinra). Med J SDU. 2021;28(COVİD-19 ÖZEL SAYI):163-6.

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