Anti-IL6R role in treatment of COVID-19-related ARDS

In this single arm study, patients with moderate to severe COVID-19 disease received one or two doses of tocilizumab (400 mg/dose) in addition to standard therapies used including lopinavir and methylprednisolone as reported in the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (6th interim edition) [2]. Better outcomes were observed in non-intubated patients with elevated baseline level of IL-6 CRP, ferritin and LDH. [...]Italian Pharmaceutical Agency (AIFA) approved a Phase II trial in 330 patients with COVID-19 induced ARDS using tocilizumab started on March 19, 2020 (https://www.aifa.gov.it/documents/20142/1127901/TOCIVID-19_Protocol_v1.3_18Marzo2020.pdf/6843930d-9f31-185d-9812-29f02ebebd76) identified in USA as NCT04317092. [...]administration of tocilizumab has not prevented influenza vaccination immune response in patients with rheumatoid arthritis [6]. its role in patients infected with SARS-CoV-2 has not yet been fully studied and is awaiting completion of clinical trials under way. [...]that time, it seems plausible to speculate that the anti-IL6R mAb plays a protective role if given at the time of overly elevated immune response to the virus, thus preventing “anaphylactic toxicity”.