The effect of tocilizumab, anakinra and prednisolone on antibody response to SARS-CoV-2 in patients with COVID-19: A prospective cohort study with multivariate analysis of factors affecting the antibody response

Başaran, Seniha; Şimşek-Yavuz, Serap; Meşe, Sevim; Çağatay, Atahan; Medetalibeyoğlu, Alpay; Öncül, Oral; Özsüt, Halit; Ağaçfidan, Ali; Gül, Ahmet; Eraksoy, Haluk

doi:10.1016/j.ijid.2021.03.031

Cited by 17 publications

(21 citation statements)

References 26 publications

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“…These infections and superinfections could be due to suppression of the immune system by blocking the IL-6 pathway which is crucial in functioning of immune system by interplay between innate and adaptive immunity [ 55 ]. IL-6 as a cytokine which also acts as a differentiation factor for B cells that can instigate the activated B cells to synthesize immunoglobulins [ 56–58 ]. As IL-6 is crucial in the synthesis of antibodies which can directly fight against the foreign pathogens like viruses, a drug like tocilizumab which acts via blocking the IL-6 receptors might affect the body’s immune defense against the COVID-19 virus by suboptimal formation of immunoglobulins from the B cells [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…IL-6 as a cytokine which also acts as a differentiation factor for B cells that can instigate the activated B cells to synthesize immunoglobulins [ 56–58 ]. As IL-6 is crucial in the synthesis of antibodies which can directly fight against the foreign pathogens like viruses, a drug like tocilizumab which acts via blocking the IL-6 receptors might affect the body’s immune defense against the COVID-19 virus by suboptimal formation of immunoglobulins from the B cells [ 56 , 57 ]. However, literature reveals that studies done by Masiá et al and Başaran et al reported that tocilizumab administration in the COVID-19 patients did not lead to decreased antibody response to SARS-CoV-2 [ 56 , 59 ].…”

Section: Discussionmentioning

confidence: 99%

“…As IL-6 is crucial in the synthesis of antibodies which can directly fight against the foreign pathogens like viruses, a drug like tocilizumab which acts via blocking the IL-6 receptors might affect the body’s immune defense against the COVID-19 virus by suboptimal formation of immunoglobulins from the B cells [ 56 , 57 ]. However, literature reveals that studies done by Masiá et al and Başaran et al reported that tocilizumab administration in the COVID-19 patients did not lead to decreased antibody response to SARS-CoV-2 [ 56 , 59 ]. In support of the findings, Cabanov et al also reported that tocilizumab do not hamper the production of anti-SARS-CoV-2 antibodies [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

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Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database

Charan

Dutta

Kaur

et al. 2021

Expert Opinion on Drug Safety

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Background Elevated inflammatory cytokines in Coronavirus disease 2019 (COVID‐19) affect the lungs leading to pneumonitis with a poor prognosis. Tocilizumab, a type of humanized monoclonal antibody antagonizing interleukin-6 receptors, is currently utilized to treat COVID-19. The present study reviews tocilizumab adverse drug events (ADEs) reported in the World Health Organization (WHO) pharmacovigilance database. Research design and methods All suspected ADEs associated with tocilizumab between April to August 2020 were analyzed based on COVID-19 patients’ demographic and clinical variables, and severity of involvement of organ system. Results A total of 1005 ADEs were reported among 513 recipients. The majority of the ADEs (46.26%) were reported from 18–64 years, were males and reported spontaneously. Around 80%, 20%, and 64% were serious, fatal, and administered intravenously, respectively. ‘Injury, Poisoning, and Procedural Complications’ remain as highest (35%) among categorized ADEs. Neutropenia, hypofibrinogenemia were common hematological ADEs. The above 64 years was found to have significantly lower odds than of below 45 years. In comparison, those in the European Region have substantially higher odds compared to the Region of Americas. Conclusion Neutropenia, superinfections, reactivation of latent infections, hepatitis, and cardiac abnormalities were common ADEs observed that necessitate proper monitoring and reporting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database

Charan

Dutta

Kaur

et al. 2021

Expert Opinion on Drug Safety

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“…SARS-CoV-2 shares certain antigenic epitopes with the retinal pigment epithelium which is in direct contact with the choroid and might induce local inflammatory damage to the choroid in these patients [14] . COVID-19 infection induces a very strong systemic inflammation that can cause severe cytokine storms and even death in some of the patients [29] . This severe systemic inflammation can potentially impair local immune privilege of the ocular structures including choroid and this choroidopathy might be a local reflection of this severe systemic inflammation, as well.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of choroidal changes following COVID-19 infection: analysis of choroidal thickness and choroidal vascularity index

Hepokur¹,

Gunes

Durmus

et al. 2023

Canadian Journal of Ophthalmology

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Purpose The aim of this study was to investigate subclinical choroidal involvement in patients with systemic COVID-19 infection and evaluate its long-term course. Materials and Methods This prospective, longitudinal study included 32 eyes of 16 COVID-19 patients and 34 eyes of 17 age-matched healthy control subjects. All of the participants had a detailed ophthalmological including visual acuity assessment, slit lamp examination and indirect ophthalmoscopy. Enhanced depth optical coherence tomography imaging of the posterior pole and peripapillary region was performed at the early (days 15-40) and late (9 th month) postinfectious periods. Choroidal vascularity index (CVI) was calculated using Image-J software. Results None of the patients had any examination finding associated with the ocular involvement of COVID-19. Subfoveal choroidal thickness (SFCT) significantly decreased at the early postinfectious period compared to healthy controls (p=0.045). SFCT significantly increased at the late postinfectious period compared to early (p=0.002) and the difference between the patients and controls became statistically insignificant (p=0.362). There was a similar trend for the peripapillary choroidal thickness measurements. CVI remained unchanged (p=0.721) despite the significant decrease in SFCT and total choroidal area (TCA, p=0.042), indicating that this decrease occurred both in choroidal stroma and blood vessels. CVI remained unchanged in the late postinfectious period (p=0.575) compared to the early period, indicating that recovery occurred in the entire choroidal tissue. Conclusion This study demonstrated that choroidal thickness was reduced in all measured areas and this decrease affected all choroidal layers. This choroidopathy was reversible and recovered at the 9 th postinfectious month.

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“…They support previous anecdotal reports that IL-1 inhibitors may not impair the immune response in the context of COVID-19. 14 Importantly, both IgG levels as well as neutralising capacity of the anti-SARS-CoV-2 antibodies were comparable in patients with AIDs…”

mentioning

confidence: 96%

Correspondence on ‘Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort’

et al. 2021

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The effect of tocilizumab, anakinra and prednisolone on antibody response to SARS-CoV-2 in patients with COVID-19: A prospective cohort study with multivariate analysis of factors affecting the antibody response

Cited by 17 publications

References 26 publications

Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database

Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database

Long-term follow-up of choroidal changes following COVID-19 infection: analysis of choroidal thickness and choroidal vascularity index

Correspondence on ‘Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort’

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