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Updated: Jun 13, 2025

Determination of the Relative Potency of an Anti-TNF Monoclonal Antibody mAb by Neutralizing TNF Using an In Vitro Bioanalytical Method
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Tumour necrosis factor-alpha inhibitors decrease mortality in COVID-19: a systematic review and meta-analysis.

Ágoston Jánosi1,2, Blanka Bódy1,2, Rita Nagy1,2

  • 1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.

Critical Care (London, England)
|June 6, 2025
PubMed
Summary
This summary is machine-generated.

Tumour necrosis factor-alpha (TNF-α) inhibitors show promise in treating severe COVID-19 by reducing mortality risk. While not impacting ventilation needs, they significantly lower C-reactive protein levels, suggesting a potential therapeutic role.

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Pharmacology

Background:

  • Severe COVID-19 is linked to a cytokine storm, where Tumour Necrosis Factor-alpha (TNF-α) plays a key role.
  • Despite vaccination, effective treatments for severe SARS-CoV-2 infection are crucial.
  • TNF-α inhibitors are being investigated for their potential in managing COVID-19 complications.

Purpose of the Study:

  • To systematically review and analyze the effectiveness, efficacy, and safety of TNF-α inhibitors in treating COVID-19 patients.
  • To compare outcomes of COVID-19 patients treated with TNF-α inhibitors versus standard care.
  • To evaluate the impact of TNF-α inhibitors on mortality, need for mechanical ventilation, and inflammatory markers.

Main Methods:

  • A systematic literature review of PubMed, Embase, and CENTRAL databases was performed.
  • Studies published up to August 12, 2024, involving COVID-19 patients treated with TNF-α inhibitors were included.
  • Outcomes including mortality, invasive mechanical ventilation, and C-reactive protein (CRP) levels were assessed using odds ratios and mean differences, with subgroup analyses for RCTs and non-randomized studies.

Main Results:

  • Seven studies with 1393 patients indicated TNF-α inhibitor use was associated with reduced mortality risk (OR 0.67, P=0.052), particularly significant in RCTs (OR 0.75, P=0.042).
  • The number needed to treat for mortality benefit was 16.
  • No significant difference in the need for invasive mechanical ventilation was found (OR 0.95, P=0.822), but a significant reduction in CRP levels was observed (MD -21.9 mg/L, P=0.024).

Conclusions:

  • TNF-α inhibition shows potential in managing severe COVID-19, evidenced by reduced mortality and CRP levels.
  • Further high-quality research is necessary to establish definitive evidence for TNF-α inhibitors in COVID-19 treatment.
  • The findings suggest a possible therapeutic avenue for cytokine storm modulation in severe SARS-CoV-2 infections.