A comprehensive review on sarilumab in COVID-19.
Introduction: The coronavirus disease 2019 (COVID-19) pandemic, caused by a newly discovered coronavirus (severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2), continues to spread all around the world. Despite the emergency of COVID-19 worldwide, remdesivir is the only treatment that has been recently approved to treat the diseases, and other effective therapies are still lacking. SARS-CoV-2 may cause severe illness in 20% of patients. Based on available data, there is an association between interleukin-6 (IL-6) and severe COVID-19. Sarilumab is a fully human immunoglobulin G1 monoclonal antibody binding to both membrane-bound and soluble IL-6 receptors with high affinity and has been considered for off-label use in the treatment of COVID-19.Areas covered: The present article reviews recently published literature focusing on the pathophysiology of COVID-19 induced cytokine storm, the potential therapeutic role, and important clinical issues of sarilumab in the treatment of COVID-19 patients.Expert opinion: The off-label treatment administration is unavoidable in the critical situation of the COVID-19 pandemic. Further efforts should be directed to determine mechanisms of SARS-CoV-2 induced immune dysregulation as well as indications of sarilumab in the patients with COVID-19 to minimize concerns regarding its off-label administration.
['Khiali|Sajad|S|', 'Rezagholizadeh|Afra|A|0000-0001-9684-6198', 'Entezari-Maleki|Taher|T|']
D000249:Adenosine Monophosphate D000409:Alanine D000818:Animals D061067:Antibodies, Monoclonal, Humanized D000998:Antiviral Agents D000086382:COVID-19 D000080424:Cytokine Release Syndrome D006801:Humans D058873:Pandemics D000086402:SARS-CoV-2
sarilumab COVID-19 SARS-CoV-2 IL-6 cytokine release syndrome end-organ damage multi-organ damage