SynthesisAnnals of the rheumatic diseases2021
Immunomodulatory therapies for SARS-CoV-2 infection: a systematic literature review to inform EULAR points to consider.
Synthesis 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 22 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Efficacy of tocilizumab in the treatment of COVID-19: An umbrella review.Reviews in medical virology · 2022Pooled it
- Pooled it
- Pooled it
- Risk of Reactivation of Hepatitis B Virus (HBV) and Tuberculosis (TB) and Complications of Hepatitis C Virus (HCV) Following Tocilizumab Therapy: A Systematic Review to Inform Risk Assessment in the COVID-19 Era.Frontiers in medicine · 2021Pooled it
- Treatment with COLchicine in hospitalized patients affected by COVID-19: The COLVID-19 trial.European journal of internal medicine · 2023Trial
- Tranilast as an Adjunctive Therapy in Hospitalized Patients with Severe COVID- 19: A Randomized Controlled Trial.Archives of medical research · 2022Trial
- Pre-intervention with intravenous immunoglobulin reverses the immunogenic clearance of PEGylated nanomedicines.Nature biomedical engineering · 2026Article
- Dexamethasone versus methylprednisolone for multiple organ dysfunction in COVID-19 critically ill patients: a multicenter propensity score matching study.BMC infectious diseases · 2024Article
- Rheumatology and Long COVID: lessons from the study of fibromyalgia.Annals of the rheumatic diseases · 2024Article
- Drug-Drug Interactions Involving Dexamethasone in Clinical Practice: Myth or Reality?Journal of clinical medicine · 2023Review
- Baricitinib combination therapy: a narrative review of repurposed Janus kinase inhibitor against severe SARS-CoV-2 infection.Infection · 2022Review
- COVID-19: autoimmunity, multisystemic inflammation and autoimmune rheumatic patients.Expert reviews in molecular medicine · 2022Review
- The Fight Against Severe COVID-19: Can Parasitic Worms Contribute?Frontiers in immunology · 2022Article
- COVID-19-induced immune thrombocytopenic purpura; Immunopathogenesis and clinical implications.Le infezioni in medicina · 2022Review
- Coronavirus Host Genomics Study: South Africa (COVIGen-SA).Global health, epidemiology and genomics · 2022Article
- The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients.Viruses · 2021Review
- Safety and Efficacy of Convalescent Plasma in COVID-19: An Overview of Systematic Reviews.Diagnostics (Basel, Switzerland) · 2021Review
- Rheumatology and COVID-19 at 1 year: facing the unknowns.Annals of the rheumatic diseases · 2021Article
- Diverse Immunological Factors Influencing Pathogenesis in Patients with COVID-19: A Review on Viral Dissemination, Immunotherapeutic Options to Counter Cytokine Storm and Inflammatory Responses.Pathogens (Basel, Switzerland) · 2021Review
- COVID-19 Immunobiology: Lessons Learned, New Questions Arise.Frontiers in immunology · 2021Review
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
Abstract
objectiveTo summarise the available information on efficacy and safety of immunomodulatory agents in SARS-CoV-2 infection.
methodsAs part of a European League Against Rheumatism (EULAR) taskforce, a systematic literature search was conducted from January 2019 to 11 December 2020. Two reviewers independently identified eligible studies according to the Population, Intervention, Comparator and Outcome framework and extracted data on efficacy and safety of immunomodulatory agents used therapeutically in SARS-CoV-2 infection at any stage. The risk of bias was assessed with validated tools.
resultsOf the 60 372 records, 401 articles were eligible for inclusion. Studies were at variable risk of bias. Randomised controlled trials (RCTs) were available for the following drugs: hydroxychloroquine (n=12), glucocorticoids (n=6), tocilizumab (n=4), convalescent plasma (n=4), interferon beta (n=2), intravenous immunoglobulins (IVIg) (n=2) and n=1 each for anakinra, baricitinib, colchicine, leflunomide, ruxolitinib, interferon kappa and vilobelimab. Glucocorticoids were able to reduce mortality in specific subsets of patients, while conflicting data were available about tocilizumab. Hydroxychloroquine was not beneficial at any disease stage, one RCT with anakinra was negative, one RCT with baricitinib+remdesivir was positive, and individual trials on some other compounds provided interesting, although preliminary, results.
conclusionAlthough there is emerging evidence about immunomodulatory therapies for the management of COVID-19, conclusive data are scarce with some conflicting data. Since glucocorticoids seem to improve survival in some subsets of patients, RCTs comparing glucocorticoids alone versus glucocorticoids plus anticytokine/immunomodulatory treatment are warranted. This systematic literature review informed the initiative to formulate EULAR 'points to consider' on COVID-19 pathophysiology and immunomodulatory treatment from the rheumatology perspective.
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What OpenQuestion holds
Registered trials
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.