The Rheumatology Drugs for COVID-19 Management: Which and When?

Abstract

INTRODUCTION:

While waiting for the development of specific antiviral therapies and vaccines to effectively neutralize the SARS-CoV2, a relevant therapeutic strategy is to counteract the hyperinflammatory status, characterized by an increase mainly of interleukin (IL)-1β, IL-2, IL-6, IL-7, IL-8, and tumor necrosis factor (TNF)-α, which hallmarks the most severe clinical cases. 'Repurposing' immunomodulatory drugs and applying clinical management approved for rheumatic diseases represents a game-changer option. In this article, we will review the drugs that have indication in patients with COVID-19, including corticosteroids, antimalarials, anti-TNF, anti-IL-1, anti-IL-6, baricitinib, intravenous immunoglobulins, and colchicine. The PubMed, Medline, and Cochrane Library databases were searched for English-language papers concerning COVID-19 treatment published between January 2020 and October 2020. Results were summarized as a narrative review due to large heterogeneity among studies. In the absence of specific treatments, the use of immunomodulatory drugs could be advisable in severe COVID-19 patients, but clinical outcomes are still suboptimal. An early detection and treatment of the complications combined with a multidisciplinary approach could allow a better recovery of these patients.

• Authors: Fabiola Atzeni, Ignazio Francesco Masala, Javier Rodríguez-Carrio, Roberto Ríos-Garcés, Elisabetta Gerratana, Laura La Corte, Manuela Giallanza, Valeria Nucera, Agostino Riva, Gerard Espinosa, Ricard Cervera
• Journal: Journal of clinical medicine (J Clin Med) Vol. 10 Issue 4 (Feb 16 2021) ISSN: 2077-0383 [Print] Switzerland
• PMID: 33669218 (Publication Type: Journal Article, Review)