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Sainz L, Riera P, Moya P, Bernal S, Casademont J, Díaz-Torné C, Millán AM, Park HS, Lasa A, Corominas H. Impact of IL6R genetic variants on treatment efficacy and toxicity response to sarilumab in rheumatoid arthritis. Arthritis Res Ther 2023; 25:226. [PMID: 38001504 PMCID: PMC10668502 DOI: 10.1186/s13075-023-03209-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Sarilumab, an IL-6 receptor antagonist, is a first-line biologic disease-modifying anti-rheumatic drug for rheumatoid arthritis. The identification of genetic biomarkers as predictors of response to sarilumab could allow for a personalized treatment strategy to improve clinical outcomes. METHODS We conducted a retrospective cohort study of 62 patients treated with sarilumab to determine whether single-nucleotide polymorphisms (SNP) in the IL6R gene could predict efficacy and toxicity responses. Six SNPs previously described in the IL6R gene (rs12083537, rs11265618, rs4329505, rs2228145, rs4537545, and rs4845625) were genotyped in DNA samples obtained from these patients. Using parametric tests, we evaluated the association between these polymorphisms and clinicopathological features. Treatment response was assessed six months after treatment initiation. Satisfactory response was based on EULAR criteria. Low disease activity was determined according to DAS28 and CDAI and quantitative improvements in DAS28 and CDAI scores. RESULTS Three SNPs (rs4845625, rs4329505 and rs11265618) were significantly associated with response outcomes. All of the SNPs, except for rs12083537, had at least one significant association with dyslipidemia or hepatotoxicity. CONCLUSIONS These findings support the potential clinical value of SNPs, particularly rs4845625, as potentially useful biomarkers to predict response to sarilumab in patients with RA.
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Affiliation(s)
- Luis Sainz
- Rheumatology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Pau Riera
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain.
- Pharmacy Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.
- Biomedical Network Research Centre On Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
| | - Patricia Moya
- Rheumatology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Sara Bernal
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Biomedical Network Research Centre On Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Genetics Department, Institut d'Investigacions Biomèdiques Sant Pau - Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Jordi Casademont
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Internal Medicine Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Cesar Díaz-Torné
- Rheumatology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Ana Milena Millán
- Rheumatology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Hye Sang Park
- Rheumatology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Adriana Lasa
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Biomedical Network Research Centre On Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Genetics Department, Institut d'Investigacions Biomèdiques Sant Pau - Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Hector Corominas
- Rheumatology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain.
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Sainz L, Riera P, Moya P, Bernal S, Casademont J, Díaz-Torné C, Millán AM, Park HS, Lasa A, Corominas H. Clinical Value of IL6R Gene Variants as Predictive Biomarkers for Toxicity to Tocilizumab in Patients with Rheumatoid Arthritis. J Pers Med 2022; 13:jpm13010061. [PMID: 36675722 PMCID: PMC9865948 DOI: 10.3390/jpm13010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Tocilizumab is a first-line biologic disease-modifying anti-rheumatic drug (bDMARD) that inhibits the interleukin-6 (IL-6) pathway by antagonizing the IL-6 receptor (IL-6R). Tocilizumab is widely used to treat rheumatoid arthritis (RA), a prevalent autoimmune disease that can cause irreversible joint damage and disability. Although many bDMARDs have been developed for RA, there is a lack of validated biomarkers which could guide personalized medicine strategies. To evaluate whether single-nucleotide polymorphisms (SNPs) in the IL6R gene could predict tocilizumab toxicity in patients with RA, we conducted a retrospective cohort study of 88 patients treated with tocilizumab. Six SNPs previously described in the IL6R gene were genotyped (rs12083537, rs11265618, rs4329505, rs2228145, rs4537545, and rs4845625). Using parametric tests, we studied the association between the SNPs and hepatotoxicity, infection, hypersensitivity, gastrointestinal, hematological, and dyslipidemia adverse events (AEs). We found associations between dyslipidemia and rs4845625 and between hematological AEs and rs11265618 and rs4329505. No further associations were found for the remaining SNPs and other AEs. Our findings support the potential clinical value of SNPs in the IL6R gene as predictive biomarkers for toxicity to tocilizumab in patients with RA.
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Affiliation(s)
- Luis Sainz
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08041 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Pau Riera
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08025 Barcelona, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (P.R.); (H.C.)
| | - Patricia Moya
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Sara Bernal
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Genetics Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08025 Barcelona, Spain
| | - Jordi Casademont
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- Medicine Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08025 Barcelona, Spain
| | - Cesar Díaz-Torné
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08041 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Ana Milena Millán
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Hye Sang Park
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Adriana Lasa
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Genetics Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08025 Barcelona, Spain
| | - Héctor Corominas
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau (HSCSP), 08041 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- Correspondence: (P.R.); (H.C.)
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Sainz L, Riera P, Moya P, Bernal S, Casademont J, Díaz-Torné C, Millán AM, Park HS, Lasa A, Corominas H. Role of IL6R Genetic Variants in Predicting Response to Tocilizumab in Patients with Rheumatoid Arthritis. Pharmaceutics 2022; 14:pharmaceutics14091942. [PMID: 36145690 PMCID: PMC9501307 DOI: 10.3390/pharmaceutics14091942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Rheumatoid arthritis (RA) is a prevalent autoimmune disease characterized by chronic arthritis that may lead to irreversible joint damage and significant disability. Patients with RA are commonly treated with Tocilizumab (TCZ), an IL-6 receptor (IL-6R) antagonist, but many patients refractorily respond to this therapy. Identifying genetic biomarkers as predictors of TCZ response could be a key to providing a personalized medicine strategy. We aimed to evaluate whether functional single nucleotide polymorphisms (SNPs) in the IL6R gene could predict TCZ response in patients with RA. We retrospectively included 88 RA patients treated with TCZ. Six SNPs previously described in the IL6R gene (rs12083537, rs11265618, rs4329505, rs2228145, rs4537545, and rs4845625) were genotyped in DNA samples from these patients. Using parametric tests, we evaluated the association between these polymorphisms and clinicopathological features. Responses to treatments were assessed at six months using three variables: a quantitative improvement in Disease activity score including 28 joints (DAS28), a satisfactory European League Against Rheumatism (EULAR) response, and low disease activity (LDA) achievement. The three response variables studied were associated with genetic variant rs4845625, and no association was found with the other five SNPs. Our findings support the potential clinical value of SNPs in the IL6R gene as predictive biomarkers for TCZ response.
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Affiliation(s)
- Luis Sainz
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Pau Riera
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (P.R.); (H.C.)
| | - Patricia Moya
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Sara Bernal
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Genetics Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Jordi Casademont
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Cesar Díaz-Torné
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Ana Milena Millán
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Hye Sang Park
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
| | - Adriana Lasa
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Genetics Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Héctor Corominas
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- Correspondence: (P.R.); (H.C.)
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Magallares B, Lobo-Prat D, Castellví I, Moya P, Gich I, Martinez-Martinez L, Park H, Millán AM, Laiz A, Díaz-Torné C, Fernandez S, Corominas H. Assessment of EULAR/ACR-2019, SLICC-2012 and ACR-1997 Classification Criteria in SLE with Longstanding Disease. J Clin Med 2021; 10:jcm10112377. [PMID: 34071275 PMCID: PMC8198204 DOI: 10.3390/jcm10112377] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Different classification criteria for systemic lupus erythematosus (SLE) have been launched over the years. Our aim was to evaluate the performance of the EULAR/ACR-2019, SLICC-2012 and ACR-1997 classification criteria in a cohort of SLE patients with longstanding disease. METHODS Descriptive observational study in 79 patients with established and longstanding SLE. The three classification criteria sets were applied to those patients. RESULTS Of the 79 patients, 70 were women (88.6%), with a mean age of 51.8 ± 14 years and a mean disease duration of 15.2 ± 11.5 years. The sensitivity of the different criteria were: 51.9%, 87.3% and 86.1% for ACR-1997, SLICC-2012 and EULAR/ACR-2019, respectively. In total, 68 out of 79 patients (53.7%) met all three classification criteria; 11.4% did not meet any classification criteria and were characterized by low SLEDAI (0.6 ± 0.9), low SLICC/ACR Damage Index (0.88 ± 0.56) and fulfilling only skin domains, antiphospholipid antibodies or hypocomplementemia. To fulfill EULAR/ACR-2019 criteria was associated with low complement levels (p < 0.04), high anti-dsDNA levels (p < 0.001), presence of lupus nephritis III-IV (p < 0.05) and arthritis (p < 0.001). CONCLUSION The EULAR/ACR-2019 classification criteria showed high sensitivity, similar to SLICC-2012, in SLE patients with longstanding disease. Patients with serological, articular or renal involvement are more likely to fulfill SLICC-2012 or EULAR/ACR-2019 criteria.
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Affiliation(s)
- Berta Magallares
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
- Sant Pau Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain;
- Department of Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - David Lobo-Prat
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
| | - Ivan Castellví
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
- Sant Pau Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain;
- Department of Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Patricia Moya
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
- Sant Pau Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain;
- Department of Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Ignasi Gich
- Sant Pau Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain;
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
| | | | - Hye Park
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
| | - Ana Milena Millán
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
| | - Ana Laiz
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
- Sant Pau Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain;
- Department of Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - César Díaz-Torné
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
- Sant Pau Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain;
- Department of Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Susana Fernandez
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
| | - Hèctor Corominas
- Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain; (B.M.); (D.L.-P.); (I.C.); (P.M.); (H.P.); (A.M.M.); (A.L.); (C.D.-T.); (S.F.)
- Sant Pau Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain;
- Department of Immunology, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Correspondence: ; Tel.: +34-932919000
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Corominas H, Castellví I, Pomar V, Antonijoan R, Mur I, Matas L, Gich I, de Benito N, Laiz A, Castillo D, Villamarin L, Filella D, Millán AM, Quijada MÁ, Puig M, Casademont J, Domingo P. Effectiveness and safety of intravenous tocilizumab to treat COVID-19-associated hyperinflammatory syndrome: Covizumab-6 observational cohort. Clin Immunol 2021; 223:108631. [PMID: 33189888 PMCID: PMC7658611 DOI: 10.1016/j.clim.2020.108631] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 02/05/2023]
Abstract
Although the starting event in COVID-19 is a viral infection some patients present with an over-exuberant inflammatory response, leading to acute lung injury (ALI) and adult respiratory distress syndrome (ARDS). Since IL-6 plays a critical role in the inflammatory response, we assessed the efficacy and safety of tocilizumab (TCZ) in this single-centre, observational study in all Covid-19 in-patient with a proven SARS-CoV-2 rapidly progressing infection to prevent ALI and ARDS. 104 patients with COVID-19 treated with TCZ had a lower mortality rate (5·8%) compared with the regional mortality rate (11%), hospitalized patient's mortality (10%), and slightly lower than hospitalized patients treated with our standard of care alone (6%). We found that TCZ rapidly decreased acute phase reactants, ferritin and liver release of proteins. D-Dimer decreased slowly. We did not observe specific safety concerns. Early administration of IL6-R antagonists in COVID-19 patients with impending hyperinflammatory response, may be safe and effective treatment to prevent, ICU admission and further complications.
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Affiliation(s)
- Hèctor Corominas
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain.
| | - Ivan Castellví
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Virginia Pomar
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Rosa Antonijoan
- Servei de Farmacología (CIBERSAM), Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Isabel Mur
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Laia Matas
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Ignasi Gich
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Natividad de Benito
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Ana Laiz
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Diego Castillo
- Servei de Respiratori, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Laura Villamarin
- Servei de Farmàcia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - David Filella
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Ana Milena Millán
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - María Ángeles Quijada
- Servei de Farmacología (CIBERSAM), Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Mireia Puig
- Servei d'Urgències, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Jordi Casademont
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Pere Domingo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
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