Acute Pneumonitis in a Patient With Adult-Onset Disease After Toclizumab Treatment With Good Response to Anakinra

Gómez, Clara Sangüesa; Robles, Bryan Josué Flores; Chinarro, B. Jara; Malpartida, María Espinosa; Mateos, C. Barbadillo

doi:10.1016/j.reumae.2015.08.005

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Drug-induced interstitial lung disease (DILD) is an infrequent adverse effect caused by tocilizumab; nevertheless, there have been post-marketing reports in large retrospective cohort studies (Curtis et al, 2015) and RCTs (Smolen et al, 2008;Fact Sheet For Healthcare Providers, 2021). The principally reported DILDs are acute pneumonitis, idiopathic pulmonary fibrosis, and exacerbation of rheumatoid arthritis-associated interstitial lung disease (Kawashiri et al, 2012;Sangüesa Gómez et al, 2016;Gouveia et al, 2020;Silva et al, 2020;Sugihara et al, 2021). The mechanism whereby tocilizumab induces interstitial lung disease is unknown; however, two mechanisms for DILD are commonly described.…”

Section: Interstitial Lung Diseasementioning

confidence: 99%

Immune-related adverse events of biological immunotherapies used in COVID-19

et al. 2022

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The use of biological immunotherapeutic drugs is one of the options currently being evaluated and employed to manage COVID-19, specifically monoclonal antibodies, which have shown benefit by regulating the excessive immune response seen in patients with severe infection, known as a cytokine storm. Tocilizumab has received particular importance for this clinical application, as has sarilumab. Both drugs share a substantial similarity in terms of pharmacodynamics, being inhibitors of the interleukin six receptor (IL-6Rα). Furthermore, sotrovimab, a neutralizing anti-SARS CoV-2 antibody, has gained the attention of the scientific community since it has recently been authorized under certain circumstances, positioning itself as a new therapeutic alternative in development. However, despite their clinical benefit, biological immunotherapies have the potential to generate life-threatening immune-related adverse events. Therefore it is essential to review their incidence, mechanism, and risk factors. This review aims to provide a comprehensive understanding of the safety of the biological immunotherapeutic drugs currently recommended for the treatment of COVID-19, provide a review of the known immune-mediated adverse events and explore the potential immune-related mechanisms of other adverse reactions.

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Section: Interstitial Lung Diseasementioning

confidence: 99%

Immune-related adverse events of biological immunotherapies used in COVID-19

et al. 2022

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“…Сама идея такой терапии противоречит знанию о плейотропности действия цитокинов, функции которых перекрываются, и блокада только одного из которых не может остановить развитие цитокинового шторма. Напротив, таргетная терапия моноклональными антителами может способствовать усилению выраженности цитокинового каскада и прогрессированию легочного повреждения [4,5,6]. При этом действие цитокинов способствует развитию тромбозов микроциркуляторного русла, повреждению всех органов и систем с быстрым прогрессированием полиорганной недостаточности.…”

Section: Introductionunclassified

Early use of cytokine adsorption in treatment of COVID-19 associated respiratory distress syndrome

Rybalko

Voronin

Vagulin

et al. 2021

Medicinskij alfavit

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Introduction. It is the recommendations for treatment of sepsis and septic shock combined with rheumatologists’ recommendations for monoclonal antibodies therapy that guide severe COVID-19 management in ICU. However, those recommendations may not be fully applied to patients with acute respiratory distress-syndrome associated with SARS-CoV-2, as there exists a difference in pathogenesis between sepsis and virus-associated pneumonias. Monoclonal antibodies therapy may contribute to cytokine cascade severity and promote lung injury. Cytokine storm aggravates the course of the disease. At present, there are two groups of methods described in literature for cytokine storm control and therapy: pharmacological and extracorporeal approaches.Materials and methods. We have performed a retrospective analysis of five COVID-19 patients with acute respiratory syndrome. Cytokine adsorption start criteria were respiratory insufficiency and IL-6 levels greater than 500 pg/ml. Adsorption therapy was initiated within 24 hours of ICU admission and continued for 48–120 hours in hemoperfusion mode on Multifiltrate machine (Fresenius Medical Care). The length of a single session of CytoSorb (Cytosorbents Inc.) therapy was 24 hours.Results. All patients demonstrated SpO2/FiO2 ratio growth and IL-6 concentration decrease by the end of hemoadsorption. We noted lymphocyte count rise as well as IgM и IgG SARS-CoV-2 antibodies titer substantial increase.Conclusions. Our observations suggest that the early start of hemoadsorption associates with gas-exchange stabilization and hinders respiratory distress progression. Hemoadsorption allows for pro-inflammatory cytokines concentrations decrease and prevents secondary lung injury. According to our data, hemoadsorption is beneficial to form a coronavirus infection specific immune response. Further research is needed for a detailed study of the results we here describe.

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Off Label Medication to Combat COVID-19: Review Results to Date

Neupane

Aman

Anuj

et al. 2021

COVID

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Background: Severe viral pneumonia cases were seen in the people of Wuhan, China at the end of December 2019. It has already affected almost every country around the globe and was declared a pandemic by the World Health Or-ganization. We aim to evaluate the therapeutics and safety of various off label COVID-19 drugs Methods: PubMed, Research Gate, Science Direct, Google Scholar, Centre for Disease control and prevention (CDC) por-tal, Chinese Centre for Disease Control and prevention (CCDC) portal, World Health Organization (WHO) portal were searched for obtaining reliable data. Result: COVID-19 is creating a storm of deaths and active cases globally which is forcing the pharmaceutical companies and scientists to work day and night to find an effective and safer anti-COVID-19 medication. Various in-vitro and clinical trials had been performed as well as currently ongoing to analyze the mechanisms and therapeutics of off label medications like Chloroquine, Hydroxychloroquine, Amodiaquine, Azithromycin, Remdesivir, Favipiravir, Ritonavir/Lopinavir, Umifenovir, Oseltamivir, Ribavirin, Nafamostat, Camostat, Tocilizumab, Ivermectin, Nitazoxanide, Famotidine, Vitamin D, Corticosteroids and Dexamethasone. In-vitro studies were performed by utilizing Vero E6 cells and hSLAM cells while open/closed, randomized/non-randomized, single-centered/multi-centered and retrospective clinical trials and cases study were organized to determined safety and efficacy Conclusion: Although these drugs have shown promising results against COVID-19 patients, it cannot be concluded that these drugs are truly safe and effective because there are no conclusive evidences to support the facts since only limited re-searches and studies had been investigated

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Acute Pneumonitis in a Patient With Adult-Onset Disease After Toclizumab Treatment With Good Response to Anakinra

Cited by 4 publications

References 7 publications

Immune-related adverse events of biological immunotherapies used in COVID-19

Immune-related adverse events of biological immunotherapies used in COVID-19

Early use of cytokine adsorption in treatment of COVID-19 associated respiratory distress syndrome

Off Label Medication to Combat COVID-19: Review Results to Date

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