Immunomodulatory therapies for the treatment of SARS-CoV-2 infection: an update of the systematic literature review to inform EULAR points to consider

被引:8
作者
Alunno, Alessia [1 ]
Najm, Aurelie [2 ]
Mariette, Xavier [3 ]
De Marco, Gabriele [4 ,5 ]
Emmel, Jenny [6 ]
Mason, Laura [6 ]
McGonagle, Dennis G. [4 ,5 ]
Machado, Pedro M. [7 ,8 ,9 ,10 ]
机构
[1] Univ Aquila, Dept Life Hlth & Environm Sci, Internal Med & Nephrol Unit, Laquila, Italy
[2] Univ Glasgow, Coll Med Vet & Life Sci, Inst Infect Immun & Inflammat, Glasgow, Lanark, Scotland
[3] Univ Paris Saclay, Dept Rheumatol, Hop Bicetre, AP HP,INSERM UMR1184, Le Kremlin Bicetre, France
[4] Univ Leeds, Leeds Inst Rheumat & Musculoskeletal Med, Leeds, W Yorkshire, England
[5] Chapel Allerton Hosp, NIHR Leeds Biomed Res Ctr, Leeds, W Yorkshire, England
[6] Leeds Teaching Hosp NHS Trust, Lib & Evidence Res Ctr, Med Educ, Leeds, W Yorkshire, England
[7] Univ Coll London Hosp UCLH NHS Fdn Trust, Univ Coll London Hosp UCL, Natl Inst Hlth Res NIHR, Biomed Res Ctr BRC, London, England
[8] London North West Univ Healthcare NHS Trust, Dept Rheumatol, Northwick Pk Hosp, London, England
[9] UCL, Ctr Rheumatol, London, England
[10] UCL, Dept Neuromuscular Dis, London, England
来源
RMD OPEN | 2021年 / 7卷 / 03期
关键词
COVID-19; biological therapy; inflammation; SEVERE COVID-19; EFFICACY; MODERATE; TRIAL;
D O I
10.1136/rmdopen-2021-001899
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To update the EULAR 2020 systematic literature review (SLR) on efficacy and safety of immunomodulatory agents in SARS-CoV-2 infection. Methods As part of a EULAR taskforce, a systematic literature search update was conducted from 11 December 2020 to 14 July 2021. Two reviewers independently identified eligible studies and extracted data on efficacy and safety of immunomodulatory agents used therapeutically in SARS-CoV-2 infection at any stage of disease. The risk of bias (RoB) was assessed with validated tools. Results Of the 26 959 records, 520 articles were eligible for inclusion. Studies were mainly at high or unclear RoB. New randomised controlled trials (RCTs) on tocilizumab clarified its benefit in patients with severe and critical COVID-19, mainly if associated with glucocorticoids. There are emergent data on the usefulness of baricitinib and tofacitinib in severe COVID-19. Other therapeutic strategies such as the use of convalescent plasma and anti-SARS-CoV-2 monoclonal antibodies showed efficacy in subjects not mounting normal anti-SARS-CoV-2 antibody responses. Conclusion This new SLR confirms that some immunomodulators (tocilizumab and JAK inhibitors) have a role for treating severe and critical COVID-19. Although better evidence is available compared with the previous SLR, the need of RCT with combination therapy (glucocorticoids+anti-cytokines) versus monotherapy with glucocorticoids still remains alongside the need for standardisation of inclusion criteria and outcomes to ultimately improve the care and prognosis of affected people. This SLR informed the 2021 update of the EULAR points to consider on the use of immunomodulatory therapies in COVID-19.
引用
收藏
页数:10
相关论文
共 53 条
[11]   Mavrilimumab in patients with severe COVID-19 pneumonia and systemic hyperinflammation (MASH-COVID): an investigator initiated, multicentre, double-blind, randomised, placebo-controlled trial [J].
Cremer, Paul C. ;
Abbate, Antonio ;
Hudock, Kristin ;
McWilliams, Carla ;
Mehta, Jinesh ;
Chang, Steven Y. ;
Sheng, Calvin C. ;
Van Tassell, Benjamin ;
Bonaventura, Aldo ;
Vecchie, Alessandra ;
Carey, Brenna ;
Wang, Qiuqing ;
Wolski, Katherine E. ;
Rajendram, Prabalini ;
Duggal, Abhijit ;
Wang, Tisha S. ;
Paolini, John F. ;
Trapnell, Bruce C. .
LANCET RHEUMATOLOGY, 2021, 3 (06) :E410-E418
[12]   RETRACTION: Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised controlled trial (Retraction of Vol 11, art no 7282, 2021) [J].
Dabbous, Hany M. ;
El-Sayed, Manal H. ;
El Assal, Gihan ;
Elghazaly, Hesham ;
Ebeid, Fatma F. S. ;
Sherief, Ahmed F. ;
Elgaafary, Maha ;
Fawzy, Ehab ;
Hassany, Sahar M. ;
Riad, Ahmed R. ;
TagelDin, Mohamed A. .
SCIENTIFIC REPORTS, 2021, 11 (01)
[13]   RETRACTED: Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised controlled trial (Retracted Article) [J].
Dabbous, Hany M. ;
El-Sayed, Manal H. ;
El Assal, Gihan ;
Elghazaly, Hesham ;
Ebeid, Fatma F. S. ;
Sherief, Ahmed F. ;
Elgaafary, Maha ;
Fawzy, Ehab ;
Hassany, Sahar M. ;
Riad, Ahmed R. ;
TagelDin, Mohamed A. .
SCIENTIFIC REPORTS, 2021, 11 (01)
[14]   Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial [J].
Darazam, Ilad Alavi ;
Shokouhi, Shervin ;
Pourhoseingholi, Mohamad Amin ;
Irvani, Seyed Sina Naghibi ;
Mokhtari, Majid ;
Shabani, Minoosh ;
Amirdosara, Mahdi ;
Torabinavid, Parham ;
Golmohammadi, Maryam ;
Hashemi, SayedPayam ;
Azimi, Arsalan ;
Maivan, Mohammad Hossein Jafarazadeh ;
Rezaei, Omidvar ;
Zali, Alireza ;
Hajiesmaeili, Mohammadreza ;
Dehbsneh, Hadiseh Shabanpour ;
Kusha, Akram Hoseyni ;
Shoushtari, Maryam Taleb ;
Khalili, Negar ;
Soleymaninia, Azam ;
Gachkar, Latif ;
Khoshkar, Ali .
SCIENTIFIC REPORTS, 2021, 11 (01)
[15]   Bamlanivimab plus Etesevimab in Mild or Moderate Covid-19 [J].
Dougan, M. ;
Nirula, A. ;
Azizad, M. ;
Mocherla, B. ;
Gottlieb, R. L. ;
Chen, P. ;
Hebert, C. ;
Perry, R. ;
Boscia, J. ;
Heller, B. ;
Morris, J. ;
Crystal, C. ;
Igbinadolor, A. ;
Huhn, G. ;
Cardona, J. ;
Shawa, I ;
Kumar, P. ;
Adams, A. C. ;
Van Naarden, J. ;
Custer, K. L. ;
Durante, M. ;
Oakley, G. ;
Schade, A. E. ;
Holzer, T. R. ;
Ebert, P. J. ;
Higgs, R. E. ;
Kallewaard, N. L. ;
Sabo, J. ;
Patel, D. R. ;
Dabora, M. C. ;
Klekotka, P. ;
Shen, L. ;
Skovronsky, D. M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (15) :1382-1392
[16]   Hydroxychloroquine in mild-to-moderate coronavirus disease 2019: a placebo-controlled double blind trial [J].
Dubee, Vincent ;
Roy, Pierre-Marie ;
Vielle, Bruno ;
Parot-Schinkel, Elsa ;
Blanchet, Odile ;
Darsonval, Astrid ;
Lefeuvre, Caroline ;
Abbara, Chadi ;
Boucher, Sophie ;
Devaud, Edouard ;
Robineau, Olivier ;
Rispal, Patrick ;
Guimard, Thomas ;
d'Anglejean, Emma ;
Diamantis, Sylvain ;
Custaud, Marc-Antoine ;
Pellier, Isabelle ;
Mercat, Alain .
CLINICAL MICROBIOLOGY AND INFECTION, 2021, 27 (08) :1124-1130
[17]   Peginterferon lambda for the treatment of outpatients with COVID-19: a phase 2, placebo-controlled randomised trial [J].
Feld, Jordan J. ;
Kandel, Christopher ;
Biondi, Mia J. ;
Kozak, Robert A. ;
Zahoor, Muhammad Atif ;
Lemieux, Camille ;
Borgia, Sergio M. ;
Boggild, Andrea K. ;
Powis, Jeff ;
McCready, Janine ;
Tan, Darrell H. S. ;
Chan, Tiffany ;
Coburn, Bryan ;
Kumar, Deepali ;
Humar, Atul ;
Chan, Adrienne ;
O'Neil, Braden ;
Noureldin, Seham ;
Booth, Joshua ;
Hong, Rachel ;
Smookler, David ;
Aleyadeh, Wesam ;
Patel, Anjali ;
Barber, Bethany ;
Casey, Julia ;
Hiebert, Ryan ;
Mistry, Henna ;
Choong, Ingrid ;
Hislop, Colin ;
Santer, Deanna M. ;
Tyrrell, D. Lorne ;
Glenn, Jeffrey S. ;
Gehring, Adam J. ;
Janssen, Harry L. A. ;
Hansen, Bettina E. .
LANCET RESPIRATORY MEDICINE, 2021, 9 (05) :498-510
[18]   Phase 2 randomized study on chloroquine, hydroxychloroquine or ivermectin in hospitalized patients with severe manifestations of SARS-CoV-2 infection [J].
Galan, Luis Enrique Bermejo ;
dos Santos, Nayara Melo ;
Asato, Mauro Shosuka ;
Araujo, Jucineide Vieira ;
de Lima Moreira, Adriana ;
Araujo, Alexia Mahara Marques ;
Paiva, Artur Diogenes Pinheiro ;
Portella, Diego Guilherme Santos ;
Marques, Frank Silas Saldanha ;
Silva, Gabriel Melo Alexandre ;
de Sousa Resende, Joana ;
Tizolim, Marycassiely Rodrigues ;
Santos, Poliana Lucenados ;
Buttenbender, Steffi Ferreira ;
de Andrade, Stephanye Batista ;
Carbonell, Roberto Carlos Cruz ;
Da Rocha, Juliana Gomes ;
de Souza, Ruy Guilherme Silveira ;
da Fonseca, Allex Jardim .
PATHOGENS AND GLOBAL HEALTH, 2021, 115 (04) :235-242
[19]  
Gordon AC, 2021, NEW ENGL J MED, V384, P1491, DOI [10.1056/NEJMoa2100433, 10.1056/NEJMc2108482]
[20]   Effect of Bamlanivimab as Monotherapy or in Combination With Etesevimab on Viral Load in Patients With Mild to Moderate COVID-19 A Randomized Clinical Trial [J].
Gottlieb, Robert L. ;
Nirula, Ajay ;
Chen, Peter ;
Boscia, Joseph ;
Heller, Barry ;
Morris, Jason ;
Huhn, Gregory ;
Cardona, Jose ;
Mocherla, Bharat ;
Stosor, Valentina ;
Shawa, Imad ;
Kumar, Princy ;
Adams, Andrew C. ;
Van Naarden, Jacob ;
Custer, Kenneth L. ;
Durante, Michael ;
Oakley, Gerard ;
Schade, Andrew E. ;
Holzer, Timothy R. ;
Ebert, Philip J. ;
Higgs, Richard E. ;
Kallewaard, Nicole L. ;
Sabo, Janelle ;
Patel, Dipak R. ;
Klekotka, Paul ;
Shen, Lei ;
Skovronsky, Daniel M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2021, 325 (07) :632-644