Medical and Surgical Intensive Care Unit, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Centre de Recherche Saint-Antoine, CRSA, Sorbonne Université, Inserm, 75012, Paris, France.
Drugs. 2023 Jan;83(1):1-36. doi: 10.1007/s40265-022-01803-2. Epub 2022 Dec 12.
Severe manifestations of COVID-19 consist of acute respiratory distress syndrome due to an initially local reaction leading to a systemic inflammatory response that results in hypoxia. Many therapeutic approaches have been attempted to reduce the clinical consequences of an excessive immune response to viral infection. To date, systemic corticosteroid therapy is still the most effective intervention. More recently, new hope has emerged with the use of interleukin (IL)-6 receptor inhibitors (tocilizumab and sarilumab). However, the great heterogeneity of the methodology and results of published studies obfuscate the true value of this treatment, leading to a confusing synthesis in recent meta-analyses, and the persistence of doubts in terms of patient groups and the appropriate time to treat. Moreover, their effects on the anti-infectious or pro-healing response are still poorly studied. This review aims to clarify the potential role of IL-6 receptor inhibitors in the treatment of severe forms of COVID-19.
COVID-19 的严重表现包括急性呼吸窘迫综合征，这是由于最初的局部反应导致全身炎症反应，从而导致缺氧。已经尝试了许多治疗方法来减轻病毒感染引起的过度免疫反应的临床后果。迄今为止，全身皮质类固醇治疗仍然是最有效的干预措施。最近，使用白细胞介素 (IL)-6 受体抑制剂（托珠单抗和沙利鲁单抗）带来了新的希望。然而，由于发表的研究在方法和结果上存在很大的异质性，使得这种治疗的真正价值变得模糊不清，导致最近的荟萃分析结果令人困惑，并且在患者群体和治疗的适当时间方面仍然存在疑问。此外，它们对抗感染或促进愈合反应的影响仍研究不足。本文旨在阐明白细胞介素-6 受体抑制剂在治疗严重 COVID-19 中的潜在作用。
