RT Journal Article
SR Electronic
T1 2021 update of the EULAR points to consider on the use of immunomodulatory therapies in COVID-19
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 34
OP 40
DO 10.1136/annrheumdis-2021-221366
VO 81
IS 1
A1 Alunno, Alessia
A1 Najm, Aurélie
A1 Machado, Pedro M
A1 Bertheussen, Heidi
A1 Burmester, Gerd-Rüdiger R
A1 Carubbi, Francesco
A1 De Marco, Gabriele
A1 Giacomelli, Roberto
A1 Hermine, Olivier
A1 Isaacs, John D
A1 Koné-Paut, Isabelle
A1 Magro-Checa, César
A1 McInnes, Iain B
A1 Meroni, Pier Luigi
A1 Quartuccio, Luca
A1 Ramanan, A V
A1 Ramos-Casals, Manuel
A1 Rodríguez Carrio, Javier
A1 Schulze-Koops, Hendrik
A1 Stamm, Tanja A
A1 Tas, Sander W
A1 Terrier, Benjamin
A1 McGonagle, Dennis G
A1 Mariette, Xavier
YR 2022
UL http://ard.bmj.com/content/81/1/34.abstract
AB Objectives To update the EULAR points to consider (PtCs) on the use of immunomodulatory therapies in COVID-19.Methods According to the EULAR standardised operating procedures, a systematic literature review up to 14 July 2021 was conducted and followed by a consensus meeting of an international multidisciplinary task force. The new statements were consolidated by formal voting.Results We updated 2 overarching principles and 12 PtC. Evidence was only available in moderate to severe and critical patients. Glucocorticoids alone or in combination with tocilizumab are beneficial in COVID-19 cases requiring oxygen therapy and in critical COVID-19. Use of Janus kinase inhibitors (baricitinib and tofacitinib) is promising in the same populations of severe and critical COVID-19. Anti-SARS-CoV-2 monoclonal antibodies and convalescent plasma may find application in early phases of the disease and in selected subgroups of immunosuppressed patients. There was insufficient robust evidence for the efficacy of other immunomodulators with further work being needed in relation to biomarker-based stratification for IL-1 therapyConclusions Growing evidence supports incremental efficacy of glucocorticoids alone or combined with tocilizumab/Janus kinase inhibitors in moderate to severe and critical COVID-19. Ongoing studies may unmask the potential application of other therapeutic approaches. Involvement of rheumatologists, as systemic inflammatory diseases experts, should be encouraged in clinical trials of immunomodulatory therapy in COVID-19.Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as online supplemental information.