Journal of Clinical Medicine (Feb 2021)

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

  • 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

DOI
https://doi.org/10.3390/jcm10040783
Journal volume & issue
Vol. 10, no. 4
p. 783

Abstract

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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.

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