Cargando…

The role of antirheumatics in patients with COVID-19

The COVID-19 pandemic has resulted in more than 2 million deaths globally. Two interconnected stages of disease are generally recognised; an initial viral stage and a subsequent immune response phase with the clinical characteristics of hyperinflammation associated with acute respiratory distress sy...

Descripción completa

Detalles Bibliográficos
Autores principales: Nissen, Christoffer B, Sciascia, Savino, de Andrade, Danieli, Atsumi, Tatsuya, Bruce, Ian N, Cron, Randy Q, Hendricks, Oliver, Roccatello, Dario, Stach, Ksenija, Trunfio, Mattia, Vinet, Évelyne, Schreiber, Karen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009617/
https://www.ncbi.nlm.nih.gov/pubmed/33817665
http://dx.doi.org/10.1016/S2665-9913(21)00062-X
_version_ 1783672911339454464
author Nissen, Christoffer B
Sciascia, Savino
de Andrade, Danieli
Atsumi, Tatsuya
Bruce, Ian N
Cron, Randy Q
Hendricks, Oliver
Roccatello, Dario
Stach, Ksenija
Trunfio, Mattia
Vinet, Évelyne
Schreiber, Karen
author_facet Nissen, Christoffer B
Sciascia, Savino
de Andrade, Danieli
Atsumi, Tatsuya
Bruce, Ian N
Cron, Randy Q
Hendricks, Oliver
Roccatello, Dario
Stach, Ksenija
Trunfio, Mattia
Vinet, Évelyne
Schreiber, Karen
author_sort Nissen, Christoffer B
collection PubMed
description The COVID-19 pandemic has resulted in more than 2 million deaths globally. Two interconnected stages of disease are generally recognised; an initial viral stage and a subsequent immune response phase with the clinical characteristics of hyperinflammation associated with acute respiratory distress syndrome. Therefore, many immune modulators and immunosuppressive drugs, which are widely used in rheumatological practice, have been proposed as treatments for patients with moderate or severe COVID-19. In this Review, we provide an overview of what is currently known about the efficacy and safety of antirheumatic therapies for the treatment of patients with COVID-19. Dexamethasone has been shown to reduce COVID-19 related mortality, interleukin-6 inhibitors to reduce risk of cardiovascular or respiratory organ support, and baricitinib to reduce time to recovery in hospitalised patients requiring oxygen support. Further studies are needed to identify whether there is any role for glucocorticoids in patients with less severe COVID-19. Although evidence on the use of other antirheumatic drugs has suggested some benefits, results from adequately powered clinical trials are urgently needed. The heterogeneity in dosing and the absence of uniform inclusion criteria and defined stage of disease studied in many clinical trials have affected the conclusions and comparability of trial results. However, after the success of dexamethasone in proving the anti-inflammatory hypothesis, the next 12 months will undoubtedly bring further clarity about the clinical utility and optimal dose and timing of other anti-rheumatic drugs in the management of COVID-19.
format Online
Article
Text
id pubmed-8009617
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Elsevier Ltd.
record_format MEDLINE/PubMed
spelling pubmed-80096172021-03-31 The role of antirheumatics in patients with COVID-19 Nissen, Christoffer B Sciascia, Savino de Andrade, Danieli Atsumi, Tatsuya Bruce, Ian N Cron, Randy Q Hendricks, Oliver Roccatello, Dario Stach, Ksenija Trunfio, Mattia Vinet, Évelyne Schreiber, Karen Lancet Rheumatol Review The COVID-19 pandemic has resulted in more than 2 million deaths globally. Two interconnected stages of disease are generally recognised; an initial viral stage and a subsequent immune response phase with the clinical characteristics of hyperinflammation associated with acute respiratory distress syndrome. Therefore, many immune modulators and immunosuppressive drugs, which are widely used in rheumatological practice, have been proposed as treatments for patients with moderate or severe COVID-19. In this Review, we provide an overview of what is currently known about the efficacy and safety of antirheumatic therapies for the treatment of patients with COVID-19. Dexamethasone has been shown to reduce COVID-19 related mortality, interleukin-6 inhibitors to reduce risk of cardiovascular or respiratory organ support, and baricitinib to reduce time to recovery in hospitalised patients requiring oxygen support. Further studies are needed to identify whether there is any role for glucocorticoids in patients with less severe COVID-19. Although evidence on the use of other antirheumatic drugs has suggested some benefits, results from adequately powered clinical trials are urgently needed. The heterogeneity in dosing and the absence of uniform inclusion criteria and defined stage of disease studied in many clinical trials have affected the conclusions and comparability of trial results. However, after the success of dexamethasone in proving the anti-inflammatory hypothesis, the next 12 months will undoubtedly bring further clarity about the clinical utility and optimal dose and timing of other anti-rheumatic drugs in the management of COVID-19. Elsevier Ltd. 2021-06 2021-03-30 /pmc/articles/PMC8009617/ /pubmed/33817665 http://dx.doi.org/10.1016/S2665-9913(21)00062-X Text en © 2021 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Review
Nissen, Christoffer B
Sciascia, Savino
de Andrade, Danieli
Atsumi, Tatsuya
Bruce, Ian N
Cron, Randy Q
Hendricks, Oliver
Roccatello, Dario
Stach, Ksenija
Trunfio, Mattia
Vinet, Évelyne
Schreiber, Karen
The role of antirheumatics in patients with COVID-19
title The role of antirheumatics in patients with COVID-19
title_full The role of antirheumatics in patients with COVID-19
title_fullStr The role of antirheumatics in patients with COVID-19
title_full_unstemmed The role of antirheumatics in patients with COVID-19
title_short The role of antirheumatics in patients with COVID-19
title_sort role of antirheumatics in patients with covid-19
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009617/
https://www.ncbi.nlm.nih.gov/pubmed/33817665
http://dx.doi.org/10.1016/S2665-9913(21)00062-X
work_keys_str_mv AT nissenchristofferb theroleofantirheumaticsinpatientswithcovid19
AT sciasciasavino theroleofantirheumaticsinpatientswithcovid19
AT deandradedanieli theroleofantirheumaticsinpatientswithcovid19
AT atsumitatsuya theroleofantirheumaticsinpatientswithcovid19
AT bruceiann theroleofantirheumaticsinpatientswithcovid19
AT cronrandyq theroleofantirheumaticsinpatientswithcovid19
AT hendricksoliver theroleofantirheumaticsinpatientswithcovid19
AT roccatellodario theroleofantirheumaticsinpatientswithcovid19
AT stachksenija theroleofantirheumaticsinpatientswithcovid19
AT trunfiomattia theroleofantirheumaticsinpatientswithcovid19
AT vinetevelyne theroleofantirheumaticsinpatientswithcovid19
AT schreiberkaren theroleofantirheumaticsinpatientswithcovid19
AT nissenchristofferb roleofantirheumaticsinpatientswithcovid19
AT sciasciasavino roleofantirheumaticsinpatientswithcovid19
AT deandradedanieli roleofantirheumaticsinpatientswithcovid19
AT atsumitatsuya roleofantirheumaticsinpatientswithcovid19
AT bruceiann roleofantirheumaticsinpatientswithcovid19
AT cronrandyq roleofantirheumaticsinpatientswithcovid19
AT hendricksoliver roleofantirheumaticsinpatientswithcovid19
AT roccatellodario roleofantirheumaticsinpatientswithcovid19
AT stachksenija roleofantirheumaticsinpatientswithcovid19
AT trunfiomattia roleofantirheumaticsinpatientswithcovid19
AT vinetevelyne roleofantirheumaticsinpatientswithcovid19
AT schreiberkaren roleofantirheumaticsinpatientswithcovid19