TNF-α Blockers Showed Prophylactic Effects in Preventing COVID-19 in Patients with Rheumatoid Arthritis and Seronegative Spondyloarthropathies: A Case–Control Study

Salesi, Mansour; Shojaie, Behrokh; Farajzadegan, Ziba; Salesi, Naghmeh; Mohammadi, Erfan

doi:10.1007/s40744-021-00342-8

Cited by 22 publications

(23 citation statements)

References 40 publications

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“…And the highest percentage of impact on the prevention of COVID-19 was related to adalimumab (96.8%). Their result could also confirm that TNF-α inhibitors may mitigate or ameliorate the COVID-19 disease course (90). Overall, patients with COVID-19 using anti-TNF therapy do not fare worse than those treated with other drugs.…”

Section: Potential Of Tnf-α Inhibitors In Covid-19mentioning

confidence: 85%

Targeting TNF-α for COVID-19: Recent Advanced and Controversies

Guo

et al. 2022

Front. Public Health

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Recent advances in the pathophysiologic understanding of coronavirus disease 2019 (COVID-19) suggests that cytokine release syndrome (CRS) has an association with the severity of disease, which is characterized by increased tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-2, IL-7, and IL-10. Hence, managing CRS has been recommended for rescuing severe COVID-19 patients. TNF-α, one of the pro-inflammatory cytokines commonly upregulated in acute lung injury, triggers CRS and facilitates SARS-CoV-2 interaction with angiotensin-converting enzyme 2 (ACE2). TNF-α inhibitors, therefore, may serve as an effective therapeutic strategy for attenuating disease progression in severe SARS-CoV-2 infection. Below, we review the possibilities and challenges of targeting the TNF-α pathway in COVID-19 treatment.

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Section: Potential Of Tnf-α Inhibitors In Covid-19mentioning

confidence: 85%

Targeting TNF-α for COVID-19: Recent Advanced and Controversies

Guo

et al. 2022

Front. Public Health

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“…Finally, Kridin et al recently analyzed outcomes of COVID-19 in patients with psoriasis treated with anti-TNF biologics and found that TNF blockade significantly decreased the risk of COVID-19 associated hospitalization. The authors did not see reduction in mortality, but mortality events were very low in this study [ 45 ]. These observations also suggest that immunosuppressive properties of TNF blockers do not exacerbate viral disease due to a weakened clearance of the pathogen.…”

Section: Blocking Tnf Upstream Of Tnf Receptorsmentioning

confidence: 70%

“…Later, a meta-analysis of more than 6000 cases revealed that TNF inhibitors administered to patients with immune-mediated inflammatory diseases alone were better protectors from severe COVID-19 associated hospitalizations and deaths than azathioprine/6-mercaptopurine or methotrexate [ 44 ]. Another study reported that TNF blockers administered to patients with rheumatoid arthritis and spondyloarthropathies significantly (by > 80%) reduced the risk of COVID-19 infection [ 45 ].…”

Section: Blocking Tnf Upstream Of Tnf Receptorsmentioning

confidence: 99%

Blocking TNF signaling may save lives in COVID-19 infection

Ablamunits

Lepsy

2022

Mol Biol Rep

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Global vaccination effort and better understanding of treatment strategies provided a ray of hope for improvement in COVID-19 pandemic, however, in many countries, the disease continues to collect its death toll. The major pathogenic mechanism behind severe cases associated with high mortality is the burst of pro-inflammatory cytokines TNF, IL-6, IFNγ and others, resulting in multiple organ failure. Although the exact contribution of each cytokine is not clear, we provide an evidence that the central mediator of cytokine storm and its devastating consequences may be TNF. This cytokine is known to be involved in activated blood clotting, lung damage, insulin resistance, heart failure, and other conditions. A number of currently available pharmaceutical agents such as monoclonal antibodies and soluble TNF receptors can effectively prevent TNF from binding to its receptor(s). Other drugs are known to block NFkB, the major signal transducer molecule used in TNF signaling, or to block kinases involved in downstream activation cascades. Some of these medicines have already been selected for clinical trials, but more work is needed. A simple, rapid, and inexpensive method of directly monitoring TNF levels may be a valuable tool for a timely selection of COVID-19 patients for anti-TNF therapy.

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“…The importance of IL-10/IFN-γ producing T cells have also been highlighted by two recent works: such a functional T cell profile was demonstrated to be defective in severe COVID-19 (30), while the presence of IL-10 producing Spike-specific T cells is characteristic of individuals with hybrid SARS-CoV-2 immunity (29) who demonstrate a robust immunity from re-infection (38,39). Of note, the demonstration that mRNA vaccination in IBD patients undergoing TNF inhibition results in the induction of T cells with an IFN-γ/IL-2/IL-10 secretion profile suggests that similar functional profiles might likewise be induced in virus-specific T cells after SARS-CoV-2 infection, explaining the clinical evidence that SARS-CoV-2 infection in different patients undergoing TNFi treatment is generally mild (40)(41)(42). In our own study, 6 patients who eventually developed COVID-19 all had a mild disease course and did not require hospitalization; 4 of whom were on TNFi.…”

Section: Discussionmentioning

confidence: 99%

Favourable vaccine-induced SARS-CoV-2 specific T cell response profile in patients undergoing immune-modifying therapies

Bert

Chan

et al. 2022

Preprint

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Patients undergoing immune-modifying therapies demonstrate a reduced humoral response after COVID-19 vaccination, but we lack a proper evaluation of the impact of such therapies on vaccine-induced T cell responses. Here, we longitudinally characterised humoral and Spike-specific T cell responses in IBD patients who are on antimetabolite therapy (azathioprine or methotrexate), TNF inhibitors and/or other biologic treatment (anti-integrin or anti-p40) after mRNA vaccination. We demonstrated that a Spike-specific T cell response is not only induced in treated IBD patients at levels similar to healthy individuals, but also sustained at higher magnitude, particularly in those treated with TNF inhibitor therapy. Furthermore, the Spike-specific T cell response in these patients is mainly preserved against mutations present in SARS-CoV-2 B.1.1.529 (Omicron) and characterized by a Th1/IL-10 cytokine profile. Thus, despite the humoral response defects, the favourable profile of vaccine-induced T cell responses might still provide a layer of COVID-19 protection to patients under immune-modifying therapies.

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TNF-α Blockers Showed Prophylactic Effects in Preventing COVID-19 in Patients with Rheumatoid Arthritis and Seronegative Spondyloarthropathies: A Case–Control Study

Cited by 22 publications

References 40 publications

Targeting TNF-α for COVID-19: Recent Advanced and Controversies

Targeting TNF-α for COVID-19: Recent Advanced and Controversies

Blocking TNF signaling may save lives in COVID-19 infection

Favourable vaccine-induced SARS-CoV-2 specific T cell response profile in patients undergoing immune-modifying therapies

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