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Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19) has spread pandemically with high rates of morbidity and mortality. COVID-19 has also posed unprecedented challenges in terms of rapid development of pharmacological countermeasures to prevent or contrast SARS-Co...

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Autores principales: Ramirez, Giuseppe A., Gerosa, Maria, Bellocchi, Chiara, Arroyo-Sánchez, Daniel, Asperti, Chiara, Argolini, Lorenza M., Gallina, Gabriele, Cornalba, Martina, Scotti, Isabella, Suardi, Ilaria, Moroni, Luca, Beretta, Lorenzo, Bozzolo, Enrica P., Caporali, Roberto, Dagna, Lorenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527378/
https://www.ncbi.nlm.nih.gov/pubmed/37759674
http://dx.doi.org/10.3390/biom13091273
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author Ramirez, Giuseppe A.
Gerosa, Maria
Bellocchi, Chiara
Arroyo-Sánchez, Daniel
Asperti, Chiara
Argolini, Lorenza M.
Gallina, Gabriele
Cornalba, Martina
Scotti, Isabella
Suardi, Ilaria
Moroni, Luca
Beretta, Lorenzo
Bozzolo, Enrica P.
Caporali, Roberto
Dagna, Lorenzo
author_facet Ramirez, Giuseppe A.
Gerosa, Maria
Bellocchi, Chiara
Arroyo-Sánchez, Daniel
Asperti, Chiara
Argolini, Lorenza M.
Gallina, Gabriele
Cornalba, Martina
Scotti, Isabella
Suardi, Ilaria
Moroni, Luca
Beretta, Lorenzo
Bozzolo, Enrica P.
Caporali, Roberto
Dagna, Lorenzo
author_sort Ramirez, Giuseppe A.
collection PubMed
description Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19) has spread pandemically with high rates of morbidity and mortality. COVID-19 has also posed unprecedented challenges in terms of rapid development of pharmacological countermeasures to prevent or contrast SARS-CoV-2 pathogenicity. Anti-SARS-CoV-2 antiviral agents and monoclonal antibodies have been specifically designed to attenuate COVID-19 morbidity and prevent mortality in vulnerable subjects, such as patients with immune-mediated diseases, but evidence for the safe and effective use of these drugs in this latter population group is scarce. Therefore, we designed a retrospective, multicentre, observational, case-control study to analyse the impact of these treatments in COVID-19 patients with systemic lupus erythematosus (SLE), a paradigmatic, multi-organ autoimmune disease. We identified 21 subjects treated with antivirals and/or monoclonal antibodies who were matched with 42 untreated patients by age, sex, SLE extension and duration. Treated patients had higher baseline SLE disease activity index 2000 scores [SLEDAI-2K median (interquartile range) = 4 (1–5) vs. 0 (0–2); p = 0.009], higher prednisone doses [5 (0–10) mg vs. 0 (0–3) mg; p = 0.002], and more severe COVID-19 symptoms by a five-point World Health Organisation-endorsed analogue scale [1 (0–1) vs. 0 (0–1); p < 0.010] compared to untreated patients. There was no difference between groups in terms of COVID-19 outcomes and sequelae, nor in terms of post-COVID-19 SLE exacerbations. Three subjects reported mild adverse events (two with monoclonal antibodies, one with nirmatrelvir/ritonavir). These data suggest that anti-SARS-CoV-2 antivirals and monoclonal antibodies might be safely and effectively used in patients with SLE, especially with active disease and more severe COVID-19 symptoms at presentation.
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spelling pubmed-105273782023-09-28 Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study Ramirez, Giuseppe A. Gerosa, Maria Bellocchi, Chiara Arroyo-Sánchez, Daniel Asperti, Chiara Argolini, Lorenza M. Gallina, Gabriele Cornalba, Martina Scotti, Isabella Suardi, Ilaria Moroni, Luca Beretta, Lorenzo Bozzolo, Enrica P. Caporali, Roberto Dagna, Lorenzo Biomolecules Article Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19) has spread pandemically with high rates of morbidity and mortality. COVID-19 has also posed unprecedented challenges in terms of rapid development of pharmacological countermeasures to prevent or contrast SARS-CoV-2 pathogenicity. Anti-SARS-CoV-2 antiviral agents and monoclonal antibodies have been specifically designed to attenuate COVID-19 morbidity and prevent mortality in vulnerable subjects, such as patients with immune-mediated diseases, but evidence for the safe and effective use of these drugs in this latter population group is scarce. Therefore, we designed a retrospective, multicentre, observational, case-control study to analyse the impact of these treatments in COVID-19 patients with systemic lupus erythematosus (SLE), a paradigmatic, multi-organ autoimmune disease. We identified 21 subjects treated with antivirals and/or monoclonal antibodies who were matched with 42 untreated patients by age, sex, SLE extension and duration. Treated patients had higher baseline SLE disease activity index 2000 scores [SLEDAI-2K median (interquartile range) = 4 (1–5) vs. 0 (0–2); p = 0.009], higher prednisone doses [5 (0–10) mg vs. 0 (0–3) mg; p = 0.002], and more severe COVID-19 symptoms by a five-point World Health Organisation-endorsed analogue scale [1 (0–1) vs. 0 (0–1); p < 0.010] compared to untreated patients. There was no difference between groups in terms of COVID-19 outcomes and sequelae, nor in terms of post-COVID-19 SLE exacerbations. Three subjects reported mild adverse events (two with monoclonal antibodies, one with nirmatrelvir/ritonavir). These data suggest that anti-SARS-CoV-2 antivirals and monoclonal antibodies might be safely and effectively used in patients with SLE, especially with active disease and more severe COVID-19 symptoms at presentation. MDPI 2023-08-22 /pmc/articles/PMC10527378/ /pubmed/37759674 http://dx.doi.org/10.3390/biom13091273 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ramirez, Giuseppe A.
Gerosa, Maria
Bellocchi, Chiara
Arroyo-Sánchez, Daniel
Asperti, Chiara
Argolini, Lorenza M.
Gallina, Gabriele
Cornalba, Martina
Scotti, Isabella
Suardi, Ilaria
Moroni, Luca
Beretta, Lorenzo
Bozzolo, Enrica P.
Caporali, Roberto
Dagna, Lorenzo
Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study
title Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study
title_full Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study
title_fullStr Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study
title_full_unstemmed Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study
title_short Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study
title_sort efficacy and safety of anti-sars-cov-2 antiviral agents and monoclonal antibodies in patients with sle: a case-control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527378/
https://www.ncbi.nlm.nih.gov/pubmed/37759674
http://dx.doi.org/10.3390/biom13091273
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