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Review
. 2020 Dec 18;1(1):90-102.
doi: 10.1016/j.medj.2020.11.005. Epub 2020 Dec 3.

The Potential for Repurposing Anti-TNF as a Therapy for the Treatment of COVID-19

Philip C Robinson  1   2 , David F L Liew  3   4 , Jean W Liew  5 , Claudia Monaco  6 , Duncan Richards  6   7 , Senthuran Shivakumar  4 , Helen L Tanner  1   2 , Marc Feldmann  6
Affiliations
Review

The Potential for Repurposing Anti-TNF as a Therapy for the Treatment of COVID-19

Philip C Robinson et al. Med. .

Abstract

Coronavirus disease 2019 (COVID-19) currently has few effective treatments. Given the uncertainty surrounding the effectiveness and uptake of a vaccine, it is important that the search for treatments continue. An exaggerated inflammatory state is likely responsible for much of the morbidity and mortality in COVID-19. Elevated levels of tumor necrosis factor (TNF), a key pro-inflammatory cytokine, have been shown to be associated with increased COVID-19 mortality. In patients with rheumatoid arthritis, TNF blockade reduces not only biologically active TNF but other pro-inflammatory cytokines important in COVID-19 hyperinflammation. Observational data from patients already on anti-TNF therapy show a reduced rate of COVID-19 poor outcomes and death compared with other immune-suppressing therapies. Anti-TNF has a long history of safe use, including in special at-risk populations, and is widely available. The case to adequately assess anti-TNF as a treatment for COVID-19 is compelling.

Keywords: SARS-CoV-2; coronavirus disease-2019; glucocorticoids; pandemic; tumor necrosis factor.

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Conflict of interest statement

P.C.R. has received personal fees from AbbVie, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Roche, and UCB; research grant funding from UCB, Janssen, Pfizer, and Novartis; and non-financial support from Bristol Myers Squibb (all unrelated to this work). D.R. has received personal fees for consultancy on drug safety from GlaxoSmithKline unrelated to the topic of this work. M.F. has held patents, now expired, on the use of infliximab and methotrexate in inflammatory arthritis and has received royalties (now ceased) from Johnson & Johnson, AbbVie, Amgen, and UCB, unrelated to this work.

Figures

Figure 1
Figure 1
Survival Over 12 Days of BALB/c Mice Intranasally Infected with 3 × 104 Plaque-Forming Units of SARS-CoV and Then Given Either Anti-TNF or Rat IgG Isotype Control From Channappanavar et al.
See this image and copyright information in PMC

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