Musculoskeletal Research Group, Institute for Infection and Immunity, St George's, University of London, London, United Kingdom.
Department of Rheumatology, St George's University Hospitals NHS Foundation Trust, London, United Kingdom.
Front Immunol. 2020 Aug 13;11:1844. doi: 10.3389/fimmu.2020.01844. eCollection 2020.
With the onset of the global pandemic in 2020 of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), there has been increasing research activity around certain disease-modifying drugs that are used for the management of inflammatory disorders such as rheumatoid arthritis, spondyloarthrosis, psoriatic arthritis, systemic lupus erythematosus, and inflammatory bowel disease for managing coronavirus symptoms. In the conditions mentioned, many people are on long-term treatment with agents including hydroxychloroquine, tumor necrosis factor alpha (TNFα) inhibitor drugs, other biologic agents such as monoclonal antibodies to IL-6 and Janus kinase inhibitors including baricitinib and tofacitinib, which are used to control inflammatory responses in their respective auto-immune condition. There is emerging data that immunomodulatory drugs could be protective at reducing certain features of SARS-CoV-2 and improving recovery. In addition, it is important to understand if subjects being treated with the immunomodulatory agents described have a less severe SARS-CoV-2 infection, as they are deemed some protection from their immunomodulatory treatment, or if they develop infections similar to non-immunocompromised patients. There is a huge unmet clinical need to advise patients responsibly about whether they should remain on their immunomodulatory treatment or not in light of Covid-19 infection. In this article we will discuss potential treatment options for SARS-CoV-2 using immunomodulatory drugs and at what stage of the condition they may be beneficial. Viable treatment options during the global coronavirus pandemic are a much-needed and an intensely active area of research.
随着 2020 年严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）全球大流行的爆发，针对某些疾病修饰药物的研究活动日益增多，这些药物用于治疗类风湿关节炎、脊柱关节炎、银屑病关节炎、系统性红斑狼疮和炎症性肠病等炎症性疾病，以控制冠状病毒症状。在上述提到的情况下，许多人长期接受羟氯喹、肿瘤坏死因子-α（TNFα）抑制剂药物、针对白细胞介素-6 的其他生物制剂和 Janus 激酶抑制剂（如巴利昔替尼和托法替布）等药物的治疗，这些药物用于控制各自自身免疫性疾病中的炎症反应。有新出现的数据表明，免疫调节剂可能具有保护作用，可以减轻 SARS-CoV-2 的某些特征并促进康复。此外，了解接受所描述的免疫调节剂治疗的患者的 SARS-CoV-2 感染是否较轻也很重要，因为他们的免疫调节治疗会提供一些保护，或者他们是否会像非免疫功能低下的患者那样发生感染。在全球新冠疫情大流行的背景下，负责任地告知患者是否应继续接受免疫调节治疗是一个巨大的、尚未满足的临床需求。在本文中，我们将讨论使用免疫调节剂治疗 SARS-CoV-2 的潜在治疗选择，以及它们在疾病的哪个阶段可能有益。在全球冠状病毒大流行期间，可行的治疗选择是一个非常需要的、研究非常活跃的领域。
