ArticleAnnals of the rheumatic diseases2021
EULAR points to consider on pathophysiology and use of immunomodulatory therapies in COVID-19.
Article in Annals of the rheumatic diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Pooled it
- Guideline
- Article
- Impact of COVID-19 Pandemic on Initiation of Immunosuppressive Treatment in Immune-Mediated Inflammatory Diseases in Austria: A Nationwide Retrospective Study.Journal of clinical medicine · 2022Article
- Observational
- Targeting the NOD-, LRR- and Pyrin Domain-Containing Protein 3 (NLRP3) Inflammasome in Psoriasis and Fatigue.Cureus · 2022Review
- Initiation of Tocilizumab or Baricitinib Were Associated With Comparable Clinical Outcomes Among Patients Hospitalized With COVID-19 and Treated With Dexamethasone.Frontiers in pharmacology · 2022Article
- [Caution with the use of dexamethasone in patients with COVID-19 in its initial phases].Revista clinica espanola · 2021Article
- Caution with the use of dexamethasone in patients with COVID-19 in its initial phases.Revista clinica espanola · 2021Article
- Article
- COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses.The Lancet. Rheumatology · 2021Review
- Tocilizumab alleviates cytokine storm with acute respiratory distress syndrome in severe SARS-CoV-2 infection in Taiwan.Internal medicine journal · 2021Article
- High-titre convalescent plasma therapy for an immunocompromised patient with systemic lupus erythematosus with protracted SARS-CoV-2 infection.BMJ case reports · 2021Article
- Pharmacological Interactions of Nintedanib and Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis in Times of COVID-19 Pandemic.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Review
- Efficacy of Different Types of Therapy for COVID-19: A Comprehensive Review.Life (Basel, Switzerland) · 2021Review
- COVID-19 and Myositis: What We Know So Far.Current rheumatology reports · 2021Review
- Rheumatology and COVID-19 at 1 year: facing the unknowns.Annals of the rheumatic diseases · 2021Article
- Circulating Calprotectin as a Biomarker of COVID-19 Severity.Expert review of clinical immunology · 2021Review
- The Impact of Recombinant Human Erythropoietin Administration in Critically ill COVID-19 Patients: A Multicenter Cohort Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
24 authors at 20 institutions in 7 countries.
Funding
Abstract
objectivesSevere systemic inflammation associated with some stages of COVID-19 and in fatal cases led therapeutic agents developed or used frequently in Rheumatology being at the vanguard of experimental therapeutics strategies. The aim of this project was to elaborate EULAR Points to consider (PtCs) on COVID-19 pathophysiology and immunomodulatory therapies.
methodsPtCs were developed in accordance with EULAR standard operating procedures for endorsed recommendations, led by an international multidisciplinary Task Force, including rheumatologists, translational immunologists, haematologists, paediatricians, patients and health professionals, based on a systemic literature review up to 15 December 2020. Overarching principles (OPs) and PtCs were formulated and consolidated by formal voting.
resultsTwo OPs and fourteen PtCs were developed. OPs highlight the heterogeneous clinical spectrum of SARS-CoV-2 infection and the need of a multifaceted approach to target the different pathophysiological mechanisms. PtCs 1-6 encompass the pathophysiology of SARS-CoV-2 including immune response, endothelial dysfunction and biomarkers. PtCs 7-14 focus on the management of SARS-CoV-2 infection with immunomodulators. There was evidence supporting the use of glucocorticoids, especially dexamethasone, in COVID-19 cases requiring oxygen therapy. No other immunomodulator demonstrated efficacy on mortality to date, with however inconsistent results for tocilizumab. Immunomodulatory therapy was not associated with higher infection rates.
conclusionsMultifactorial pathophysiological mechanisms, including immune abnormalities, play a key role in COVID-19. The efficacy of glucocorticoids in cases requiring oxygen therapy suggests that immunomodulatory treatment might be effective in COVID-19 subsets. Involvement of rheumatologists, as systemic inflammatory diseases experts, should continue in ongoing clinical trials delineating optimal immunomodulatory therapy utilisation in COVID-19.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.