Correspondence on ‘Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry’ by Gianfrancescoet al. Compassionate use of tocilizumab in severe COVID-19 with hyperinflammation prior to advent of clinical trials – a real-world district general hospital experience
| Autor: | Naveen Bhadauria, Jeronimo Moreno-Cuesta, Thomas Axon, Alice Cole, Asim Khan, Daud Abdulla, Jessica J Manson, Zozik Fattah, Munzir El-Hassan, Dev Mukerjee |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Immunology Disease General Biochemistry Genetics and Molecular Biology law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Rheumatology law Internal medicine Epidemiology Pandemic medicine Immunology and Allergy Intensive care medicine 030203 arthritis & rheumatology business.industry Intensive care unit Clinical trial 030104 developmental biology chemistry Observational study business |
| Zdroj: | Annals of the Rheumatic Diseases |
| ISSN: | 1468-2060 0003-4967 |
| Popis: | The coronavirus disease 2019 (COVID-19) has resulted in a global pandemic with multiple casualties. Within the UK, specific groups of patients including those with rheumatic diseases requiring significant immunosuppression were advised to shield from the public to protect themselves from COVID-19 during the heart of the pandemic.1 In their important paper, Gianfrancesco et al found lower rates of hospitalisation in patients with rheumatic diseases with COVID-19 who were taking traditional synthetic and biological disease modifying antirheumatic drugs (DMARDs).2 With regard to biologic DMARDs, most of their registry patients were taking tumour necrosis factor inhibitors but did also include other therapies including interleukin-6 (IL-6) antagonists. They also provide an interesting suggestion of the potential benefit of biologic DMARD therapy in COVID-19 patients particularly in cases associated with a hyperinflammatory response. Indeed, it has been recognised that subsets of COVID-19 patients can develop a cytokine storm involving the uncontrolled production of cytokines such as IL-6.3 4 Moreover, observational studies suggest the potential benefit of IL-6-antagonism using tocilizumab (TOC).5–7 Internationally, TOC has been used in Italy, China and Ireland.8–10 Early during the UK pandemic, there was no access to clinical trials. Moreover, our Trust faced the second highest pressure index in the UK in relation to the number of admissions of COVID-19 patients.11 Our intensive care unit and … |
| Databáze: | OpenAIRE |
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