medwireNews: EULAR has updated its points to consider on the use of immunomodulatory therapies for the treatment of COVID-19 in light of the most recent evidence.
This update provides guidance from a rheumatology perspective and “opens the way to a new paradigm: the treatment of immunopathology associated with severe and critical acute infections may benefit from immunomodulatory treatments usually given for autoimmune and inflammatory diseases,” say the authors.
Xavier Mariette (INSERM UMR1184, Paris, France) and colleagues’ guidance was developed via a consensus meeting of a multidisciplinary international taskforce and based on a systematic literature review. They recommend that glucocorticoids, given alone or with tocilizumab, are beneficial for patients with critical COVID-19 or those requiring oxygen therapy, while use of the Janus kinase inhibitors tofacitinib and baricitinib “is promising in the same populations.”
The authors also note that monoclonal antibodies against SARS-CoV-2 and convalescent plasma may be beneficial in early COVID-19 and in certain subgroups of immunosuppressed patients. However, there was insufficient evidence to recommend the use of other immunomodulatory drugs, including interferon inhibitors, leflunomide, or cyclosporin, and they say that further research into biomarker-based stratification is needed for interleukin-1 inhibitors such as anakinra.
Mariette et al emphasize the importance of involving rheumatologists, “as systemic inflammatory diseases experts,” in studies of immunomodulatory treatment for COVID-19.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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