A comprehensive review on sarilumab in COVID-19

Area of Science:

• Immunology
• Virology
• Pharmacology

Background:

• The COVID-19 pandemic, caused by SARS-CoV-2, has a significant impact, with limited approved treatments beyond remdesivir.
• Severe COVID-19 illness is associated with a cytokine storm, linked to elevated interleukin-6 (IL-6) levels.
• Sarilumab, an IL-6 receptor antagonist, presents a potential therapeutic option for severe COVID-19.

Purpose of the Study:

• To review the pathophysiology of COVID-19-induced cytokine storm.
• To evaluate the potential therapeutic role of sarilumab in COVID-19 treatment.
• To discuss clinical considerations for off-label sarilumab use in COVID-19 patients.

Main Methods:

• Literature review of recent publications on COVID-19 pathophysiology and treatment.
• Focus on studies related to cytokine storm and IL-6 signaling in COVID-19.
• Analysis of sarilumab's mechanism of action and clinical data.

Main Results:

• The review highlights the association between IL-6 and severe COVID-19.
• Sarilumab's high affinity for IL-6 receptors suggests a potential benefit in mitigating cytokine storm.
• Off-label use of sarilumab is considered in the context of the pandemic's urgency.

Conclusions:

• Off-label administration of sarilumab is currently unavoidable for critical COVID-19 cases.
• Further research is needed to elucidate SARS-CoV-2 immune dysregulation mechanisms.
• Defining specific indications for sarilumab in COVID-19 patients is crucial to address off-label use concerns.