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托珠单抗与新型冠状病毒肺炎

Tocilizumab and COVID-19.

作者信息

Chaudhry Dhruva, Singh Pawan K

机构信息

Department of Pulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.

出版信息

Indian J Crit Care Med. 2020 Sep;24(9):741-743. doi: 10.5005/jp-journals-10071-23608.


DOI:10.5005/jp-journals-10071-23608
PMID:33132549
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7584849/
Abstract

The number of cases in COVID-19 pandemic is rising rapidly. There has not been a single effective proven medication for COVID-19 disease. Highest mortality has been reported among subjects who develop acute respiratory disease (ARDS). The histopathological analysis of lung specimens has given rise to theories that propose the major role of cytokine release syndrome in the development of ARDS. IL-6 has often been found to be raised in subjects having severe disease. Tocilizumab is a selective inhibitor of the IL-6 pathway and has been approved for various rheumatological diseases. Its use in COVID-19 has been evaluated following the success of other immunosuppressive drugs like steroids. The data in support of against its use in COVID19 are lacking. Similarly, the risk of early- and late-onset infections after tocilizumab in COVID-19 remains unknown. The study by Nasa et al. is a valuable addition to the evidence concerning its use. Despite multiple articles, its safety and efficacy in COVID-19 remain unknown. Caution must be used about its timing and role of IL-6 levels for disease monitoring. Chaudhry D, Singh PK. Tocilizumab and COVID-19. Indian J Crit Care Med 2020;24(9):741-743.

摘要

新型冠状病毒肺炎大流行中的病例数正在迅速上升。目前尚未有经证实有效的治疗新型冠状病毒肺炎的药物。据报道,在发生急性呼吸窘迫综合征(ARDS)的患者中死亡率最高。对肺标本的组织病理学分析引发了一些理论,这些理论认为细胞因子释放综合征在ARDS的发生发展中起主要作用。在患有严重疾病的患者中,经常发现白细胞介素-6(IL-6)升高。托珠单抗是IL-6通路的选择性抑制剂,已被批准用于多种风湿性疾病。继类固醇等其他免疫抑制药物取得成功后,其在新型冠状病毒肺炎中的应用也得到了评估。目前缺乏支持或反对其在新型冠状病毒肺炎中使用的数据。同样,新型冠状病毒肺炎患者使用托珠单抗后早发和迟发感染的风险仍然未知。纳萨等人的研究为有关其使用的证据增添了有价值的内容。尽管有多篇文章,但托珠单抗在新型冠状病毒肺炎中的安全性和有效性仍然未知。在使用托珠单抗时必须谨慎,并注意IL-6水平在疾病监测中的时机和作用。乔杜里D,辛格PK。托珠单抗与新型冠状病毒肺炎。《印度重症监护医学杂志》2020;24(9):741 - 743。

相似文献

[1]
Tocilizumab and COVID-19.

Indian J Crit Care Med. 2020-9

[2]
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Indian J Crit Care Med. 2020-9

[3]
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Indian J Crit Care Med. 2021-4

[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Therapeutic Impact of Tocilizumab in the Setting of Severe COVID-19; an Updated and Comprehensive Review on Current Evidence.

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[2]
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[3]
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[4]
Drug-induced liver injury following the use of tocilizumab or sarilumab in patients with coronavirus disease 2019.

BMC Infect Dis. 2022-12-12

[5]
Clinical experience of tocilizumab treatment among a cohort of patients with COVID-19 infection from Western India.

J Family Med Prim Care. 2022-1

[6]
Tofacitinib Associated with Reduced Intubation Rates in the Management of Severe COVID-19 Pneumonia: A Preliminary Experience.

Indian J Crit Care Med. 2021-10

[7]
COVID-19 infection and liver injury: Clinical features, biomarkers, potential mechanisms, treatment, and management challenges.

World J Clin Cases. 2021-8-6

[8]
Multimodality treatment in immunocompromised patients with severe COVID-19: the role of IL-6 inhibitor, intravenous immunoglobulin, and haemoperfusion.

Respirol Case Rep. 2021-3-7

本文引用的文献

[1]
COVACTA trial raises questions about tocilizumab's benefit in COVID-19.

Lancet Rheumatol. 2020-10

[2]
Tocilizumab in patients with severe COVID-19: a retrospective cohort study.

Lancet Rheumatol. 2020-8

[3]
Late onset infectious complications and safety of tocilizumab in the management of COVID-19.

J Med Virol. 2021-3

[4]
Low-dose subcutaneous tocilizumab to prevent disease progression in patients with moderate COVID-19 pneumonia and hyperinflammation.

Int J Infect Dis. 2020-8-6

[5]
Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review.

Pulmonology. 2021

[6]
COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS.

Med J Aust. 2020-7

[7]
Tocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019: Survival and Clinical Outcomes.

Chest. 2020-6-15

[8]
Cytokine storm and leukocyte changes in mild versus severe SARS-CoV-2 infection: Review of 3939 COVID-19 patients in China and emerging pathogenesis and therapy concepts.

J Leukoc Biol. 2020-6-13

[9]
Higher levels of IL-6 early after tocilizumab distinguish survivors from nonsurvivors in COVID-19 pneumonia: A possible indication for deeper targeting of IL-6.

J Med Virol. 2020-7-22

[10]
Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy.

Autoimmun Rev. 2020-5-3

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