Department of Pharmacy, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, Anhui, China.
Infection Department, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, Anhui, China.
Clin Drug Investig. 2020 Jun;40(6):511-518. doi: 10.1007/s40261-020-00917-3.
Since December 2019, a novel coronavirus pneumonia (COVID-19) has broken out in Wuhan, China and spread rapidly. Recent studies have found that ⁓ 15.7% of patients develop severe pneumonia, and cytokine storm is an important factor leading to rapid disease progression. Currently, there are no specific drugs for COVID-19 and the cytokine storm it causes. IL-6 is one of the key cytokines involved in infection-induced cytokine storm. Tocilizumab, which is the IL-6 receptor antagonist, has been approved by the US FDA for the treatment of cytokine release syndrome (CRS), is expected to treat cytokine storm caused by COVID-19 and is now in clinical trials. In this paper, we will elaborate the role of cytokine storm in COVID-19, the mechanism of tocilizumab on cytokine storm and the key points of pharmaceutical care based on the actual clinical application for COVID-19 in our hospital, the latest research reports, clinical trial progress of tocilizumab, drug instruction from the US FDA, and "Diagnosis and Treatment Plan of Novel Coronavirus Pneumonia (seventh trial edition)" in China, so as to provide reference for the treatment of COVID-19.
自 2019 年 12 月以来,新型冠状病毒肺炎(COVID-19)在中国武汉爆发并迅速传播。最近的研究发现, ⁓ 15.7%的患者发展为重症肺炎,细胞因子风暴是导致疾病快速进展的重要因素。目前,COVID-19 及其引起的细胞因子风暴尚无特效药物。白细胞介素 6(IL-6)是感染诱导的细胞因子风暴中涉及的关键细胞因子之一。托珠单抗是一种 IL-6 受体拮抗剂,已被美国食品药品监督管理局(FDA)批准用于治疗细胞因子释放综合征(CRS),有望治疗 COVID-19 引起的细胞因子风暴,目前正在临床试验中。本文将根据我院 COVID-19 的实际临床应用、最新研究报告、托珠单抗的临床试验进展、美国 FDA 的药物说明书以及中国的《新型冠状病毒肺炎诊疗方案(试行第七版)》,阐述细胞因子风暴在 COVID-19 中的作用、托珠单抗对细胞因子风暴的作用机制以及药学监护要点,为 COVID-19 的治疗提供参考。