Anti-TNF therapy as potential treatment for COVID-19

  • Heather Mason
  • Univadis Medical News
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Authors writing in Lancet propose that there is sufficient evidence and an urgent need for anti-TNF therapy trials in the fight against COVID-19. 

Deaths from COVID-19 are chiefly due to a major immune inflammatory response and diffuse alveolar damage. The pro-inflammatory cytokine upregulation (interleukin (IL)-1, IL-6, TNF, and interferon γ) documented in this disease is a valid target for anti-TNF therapy.

Among the many anti-inflammatory candidates for COVID-19, only a few anti-TNF antibodies such as (infliximab or adalimumab) are potentially effective, widely available, and have a well-established safety profile. This treatment should be evaluated in patients with COVID-19 on hospital admission to prevent progression to the requirement of intensive care support.

Blockade of TNF alone is clinically effective in many diseases, despite the presence of other pro-inflammatory cytokines and mediators. A single infusion of anti-TNF antibody might reduce some of the processes that occur during COVID-19 lung inflammation, reducing TNF and other inflammatory mediators, cellularity, and exudate.

The best time for this therapy in patients with COVID-19 is as early as possible after hospital admission because patients will already have initiated anti-viral immunity for several days.

There is sufficient evidence to support clinical trials of anti-TNF therapy in patients with COVID-19. Study subjects should be initiated on this therapy as early as possible. If anti-TNFs are beneficial and safe in hospitalised subjects, out of hospital treatment of COVID-19 patients at high risk could be considered.