J Immunother Cancer . Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy

[tetano]

J Immunother Cancer


. 2020 Aug;8(2):e001089.
doi: 10.1136/jitc-2020-001089.
Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy


Vincenzo Montesarchio ^{# 1} , Roberto Parella ^{# 2} , Chiara Iommelli ¹ , Antonella Bianco ¹ , Elio Manzillo ² , Fiorentino Fraganza ³ , Cristiana Palumbo ⁴ , Gaetano Rea ⁴ , Patrizia Murino ³ , Rosanna De Rosa ³ , Luigi Atripaldi ⁴ , Maurizio D'Abbraccio ² , Marcello Curvietto ⁵ , Domenico Mallardo ⁵ , Egidio Celentano ⁶ , Antonio Maria Grimaldi ⁵ , Marco Palla ⁵ , Claudia Trojaniello ⁵ , Maria Grazia Vitale ⁵ , Samuel Lewis Million-Weaver ⁷ , Paolo Antonio Ascierto ⁸



Affiliations

• PMID: 32784217
• DOI: 10.1136/jitc-2020-001089

Abstract

Background: The inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing.
Study description: In this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease.
Conclusions: This observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.

Keywords: case reports; immunomodulation; inflammation mediators.