tetano
Editor, Senior Moderator
J Immunother Cancer
. 2020 Aug;8(2):e001089.
doi: 10.1136/jitc-2020-001089.
Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy
Vincenzo Montesarchio[SUP] #[/SUP][SUP] 1 [/SUP], Roberto Parella[SUP] #[/SUP][SUP] 2 [/SUP], Chiara Iommelli[SUP] 1 [/SUP], Antonella Bianco[SUP] 1 [/SUP], Elio Manzillo[SUP] 2 [/SUP], Fiorentino Fraganza[SUP] 3 [/SUP], Cristiana Palumbo[SUP] 4 [/SUP], Gaetano Rea[SUP] 4 [/SUP], Patrizia Murino[SUP] 3 [/SUP], Rosanna De Rosa[SUP] 3 [/SUP], Luigi Atripaldi[SUP] 4 [/SUP], Maurizio D'Abbraccio[SUP] 2 [/SUP], Marcello Curvietto[SUP] 5 [/SUP], Domenico Mallardo[SUP] 5 [/SUP], Egidio Celentano[SUP] 6 [/SUP], Antonio Maria Grimaldi[SUP] 5 [/SUP], Marco Palla[SUP] 5 [/SUP], Claudia Trojaniello[SUP] 5 [/SUP], Maria Grazia Vitale[SUP] 5 [/SUP], Samuel Lewis Million-Weaver[SUP] 7 [/SUP], Paolo Antonio Ascierto[SUP] 8 [/SUP]
Affiliations
Abstract
Background: The inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing.
Study description: In this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease.
Conclusions: This observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.
Keywords: case reports; immunomodulation; inflammation mediators.
. 2020 Aug;8(2):e001089.
doi: 10.1136/jitc-2020-001089.
Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy
Vincenzo Montesarchio[SUP] #[/SUP][SUP] 1 [/SUP], Roberto Parella[SUP] #[/SUP][SUP] 2 [/SUP], Chiara Iommelli[SUP] 1 [/SUP], Antonella Bianco[SUP] 1 [/SUP], Elio Manzillo[SUP] 2 [/SUP], Fiorentino Fraganza[SUP] 3 [/SUP], Cristiana Palumbo[SUP] 4 [/SUP], Gaetano Rea[SUP] 4 [/SUP], Patrizia Murino[SUP] 3 [/SUP], Rosanna De Rosa[SUP] 3 [/SUP], Luigi Atripaldi[SUP] 4 [/SUP], Maurizio D'Abbraccio[SUP] 2 [/SUP], Marcello Curvietto[SUP] 5 [/SUP], Domenico Mallardo[SUP] 5 [/SUP], Egidio Celentano[SUP] 6 [/SUP], Antonio Maria Grimaldi[SUP] 5 [/SUP], Marco Palla[SUP] 5 [/SUP], Claudia Trojaniello[SUP] 5 [/SUP], Maria Grazia Vitale[SUP] 5 [/SUP], Samuel Lewis Million-Weaver[SUP] 7 [/SUP], Paolo Antonio Ascierto[SUP] 8 [/SUP]
Affiliations
- PMID: 32784217
- DOI: 10.1136/jitc-2020-001089
Abstract
Background: The inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing.
Study description: In this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease.
Conclusions: This observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.
Keywords: case reports; immunomodulation; inflammation mediators.