Thalidomide combined with low‐dose short‐term glucocorticoid in the treatment of critical Coronavirus Disease 2019

Chen, Chengshui; Feng, Qi; Shi, Ke‐Qing; Li, Yuping; Li, Ji; Chen, Yongping; Pan, Jingye; Zhou, Tong; Lin, Xiangyang; Zhang, Jin‐San; Luo, Yongde; Li, Xiaokun; Xia, Jinglin

doi:10.1002/ctm2.35

Cited by 65 publications

(77 citation statements)

References 18 publications

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“…Drugs to decrease the inflammation associated with COVID‐19 are also being evaluated. One of these drugs is thalidomide that may decrease inflammation through its antiinflammatory and immunomodulatory effects 126 …”

Section: Other Emerging Therapies For Treatment Of Covid‐19mentioning

confidence: 99%

Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019

et al. 2020

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The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has evolved into an emergent global pandemic. Coronavirus disease 2019 (COVID‐19) can manifest on a spectrum of illness from mild disease to severe respiratory failure requiring intensive care unit admission. As the incidence continues to rise at a rapid pace, critical care teams are faced with challenging treatment decisions. There is currently no widely accepted standard of care in the pharmacologic management of patients with COVID‐19. Urgent identification of potential treatment strategies is a priority. Therapies include novel agents available in clinical trials or through compassionate use, and other drugs, repurposed antiviral and immunomodulating therapies. Many have demonstrated in vitro or in vivo potential against other viruses that are similar to SARS‐CoV‐2. Critically ill patients with COVID‐19 have additional considerations related to adjustments for organ impairment and renal replacement therapies, complex lists of concurrent medications, limitations with drug administration and compatibility, and unique toxicities that should be evaluated when utilizing these therapies. The purpose of this review is to summarize practical considerations for pharmacotherapy in patients with COVID‐19, with the intent of serving as a resource for health care providers at the forefront of clinical care during this pandemic.

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Section: Other Emerging Therapies For Treatment Of Covid‐19mentioning

confidence: 99%

Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019

et al. 2020

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“…Cytokines such as IL-6, IL-10, IFN-γ all decreased to normal range. 15 Proposed mechanisms are as follows: thalidomide inhibits NF-κB, which further suppresses the production of pro-inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and IL-8, and prevents the cytokine surge. It also regulates immune function by activating T cells and T-cell receptors.…”

Section: Thalidomidementioning

confidence: 99%

“…Moreover, the sedative and antiemetic property of thalidomide helps anxious patients calm down, which reduces oxygen consumption. 15 Now, at least one clinical trial has been conducted to investigate the efficacy and safety of thalidomide as an adjuvant therapy for COVID-19 pneumonia. 29 Part II: DMARDs with antiviral potential other than SARS-CoV-2 Many oral DMARDs have inherent antiviral activity and could be the treatment of choice for patients with coexisting immune-based diseases and infections.…”

Section: Thalidomidementioning

confidence: 99%

Oral disease-modifying antirheumatic drugs and immunosuppressants with antiviral potential, including SARS-CoV-2 infection: a review

Tsai

2020

Therapeutic Advances in Musculoskeletal

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There have been several episodes of viral infection evolving into epidemics in recent decades, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the latest example. Its high infectivity and moderate mortality have resulted in an urgent need to find an effective treatment modality. Although the category of immunosuppressive drugs usually poses a risk of infection due to interference of the immune system, some of them have been found to exert antiviral properties and are already used in daily practice. Recently, hydroxychloroquine and baricitinib have been proposed as potential drugs for SARS-CoV-2. In fact, there are other immunosuppressants known with antiviral activities, including cyclosporine A, hydroxyurea, minocycline, mycophenolic acid, mycophenolate mofetil, leflunomide, tofacitinib, and thalidomide. The inherent antiviral activity could be a treatment choice for patients with coexisting rheumatological disorders and infections. Clinical evidence, their possible mode of actions and spectrum of antiviral activities are included in this review article. Lay summary Immunosuppressants often raise the concern of infection risks, especially for patients with underlying immune disorders. However, some disease-modifying antirheumatic drugs (DMARDs) with inherent antiviral activity would be a reasonable choice in the situation of concomitant viral infections and flare up of autoimmune diseases. This review covers DMARDs of treatment potential for SARS-CoV-2 in part I, and antiviral mechanisms plus trial evidence for viruses other than SARS-CoV-2 in part II.

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“…Thalidomide, an immunomodulatory and anti-in ammatory agent, was case-reported the protective effect on lung injury and immunological stress caused by COVID-19 pneumonia in combination with antiviral drugs and low-dose glucocorticoid [17]. The acute pulmonary effusion symptoms and the elevated in ammatory cytokine pro les including IFN-γ, IL-6 and IL-10 were reduced, and the number of lymphocytes recovered [65]. In a two-year randomized controlled trial on early seropositive rheumatoid arthritis patients, minocycline achieved better anti-in ammatory outcomes than hydroxychloroquine [66].…”

Section: Ifs-suppressing Treatment Of Covid-19mentioning

confidence: 99%

Minocycline Might Be an Adjunctive Therapy Option for the Treatment of COVID-19: In Silico Screening, Structure-affinity Relationship, and Literature Review

Xiao¹

2020

Preprint

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Abstract Up to now, there is no specific therapy for the globally ongoing COVID-19. To explore potential inhibitors of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) for the treatment of novel coronavirus disease (COVID-19), in silico screening of 135 clinical drugs was performed targeting on 3-chymotrypsin-like protease (3CLpro, or M pro ). Six drugs including anti-HIV drug (raltegravir), antibacterial drugs (cefonicid, cefoperazone, minocycline), and antidiabetic drugs (canaglifozin, glyburide) showed high binding affinities (≤ -8.5 kcal/mol) and interesting binding conformations compared with the designed co-crystal ligand N3 (-7.7 kcal/mol). In which the antibiotic minocycline, an inhibitor of bacterial ribosomal rRNA, showed the highest binding affinity (-9.6 kcal/mol). Valuable hydrogen bonding and hydrophobic interactions were found between minocycline and Mpro active site. Beside the hydrogen bond with Cys145, minocycline formed a Pi-Cation with His41, which strongly supported minocycline as a Michael Addition acceptor to bind with the catalytic site of Mpro . The structure-affinity relationship was studied based on molecular docking of minocycline analogues. Literature review found that minocycline had both in vitro and in vivo broad-spectrum antiviral as well as anti-inflammatory activities, and the levels of a broad-spectrum of biological markers during minocycline administration were opposed to those of COVID-19 condition (both severe and non-severe). Minocycline deserves in vitro and in vivo evaluations as SARS-CoV-2 inhibitor as well as a randomized controlled trial to investigate the efficacy for COVID-19. These studies will shed new light on an adjuvant treatment strategy for this potentially lethal viral disease.

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Thalidomide combined with low‐dose short‐term glucocorticoid in the treatment of critical Coronavirus Disease 2019

Cited by 65 publications

References 18 publications

Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019

Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019

Oral disease-modifying antirheumatic drugs and immunosuppressants with antiviral potential, including SARS-CoV-2 infection: a review

Minocycline Might Be an Adjunctive Therapy Option for the Treatment of COVID-19: In Silico Screening, Structure-affinity Relationship, and Literature Review

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