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Review
. 2021 Feb 16;10(4):783.
doi: 10.3390/jcm10040783.

The Rheumatology Drugs for COVID-19 Management: Which and When?

Fabiola Atzeni  1   2 , Ignazio Francesco Masala  3 , Javier Rodríguez-Carrio  4   5 , Roberto Ríos-Garcés  6 , Elisabetta Gerratana  1 , Laura La Corte  1 , Manuela Giallanza  1 , Valeria Nucera  1 , Agostino Riva  7 , Gerard Espinosa  6 , Ricard Cervera  6
Affiliations
Review

The Rheumatology Drugs for COVID-19 Management: Which and When?

Fabiola Atzeni et al. J Clin Med. .

Abstract

While waiting for the development of specific antiviral therapies and vaccines to effectively neutralize the SARS-CoV2, a relevant therapeutic strategy is to counteract the hyperinflammatory status, characterized by an increase mainly of interleukin (IL)-1β, IL-2, IL-6, IL-7, IL-8, and tumor necrosis factor (TNF)-α, which hallmarks the most severe clinical cases. 'Repurposing' immunomodulatory drugs and applying clinical management approved for rheumatic diseases represents a game-changer option. In this article, we will review the drugs that have indication in patients with COVID-19, including corticosteroids, antimalarials, anti-TNF, anti-IL-1, anti-IL-6, baricitinib, intravenous immunoglobulins, and colchicine. The PubMed, Medline, and Cochrane Library databases were searched for English-language papers concerning COVID-19 treatment published between January 2020 and October 2020. Results were summarized as a narrative review due to large heterogeneity among studies. In the absence of specific treatments, the use of immunomodulatory drugs could be advisable in severe COVID-19 patients, but clinical outcomes are still suboptimal. An early detection and treatment of the complications combined with a multidisciplinary approach could allow a better recovery of these patients.

Keywords: COVID-19; HCQ; SARS-CoV2; anti-IL-6 drugs; pneumonia.

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Conflict of interest statement

The authors declare that they have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
SARS-CoV-2-induced cytokine storm, the inflammatory pathway, and mechanisms of actions of the different drugs used to blocks this.
See this image and copyright information in PMC

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