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Anales de la Academia de Ciencias de Cuba
versão On-line ISSN 2304-0106
Resumo
CROMBET RAMOS, Tania et al. Reprofiling the anti-CD6 antibody for the treatment of patients with COVID-19. Anales de la ACC [online]. 2021, vol.11, n.3 Epub 01-Dez-2021. ISSN 2304-0106.
Introduction:
COVID-19 can lead to a hyper-inflammatory state. CD6 is a glycoprotein expressed on mature T-lymphocytes, which is a crucial regulator of the T-cell activation. Itolizumab is an antibody targeting CD6. Clinical data in autoimmune diseases indicate that it lowers multiple cytokines primarily involving the Th1/Th17 pathway. Objective: to preliminarily assess the safety and impact of itolizumab on interleukin-6, pulmonary function and mortality of COVID-19 patients.
Methods:
Sixty-eight moderate, severe and critical patients were included in an expanded-access trial in Cuba. Itolizumab was administered together with other therapies included in the national protocol for SARS-CoV-2.
Results:
All patients completed the first infusion and 41 received 2 doses. Median age was 68 and 94 % have comorbidities. Itolizumab improved the lung function and was well tolerated; 3 subjects had related serious adverse events. Interleukin-6 decreased in individuals with high levels and did not change in those with lower concentration. 14-day lethality rate was 4 % and 18 % for moderate and severe patients. Although this was not a randomized study, preliminary data suggest that itolizumab reduced the death probability in comparison to controls. Time to treatment, neurological manifestations, biomarkers like NLR, neutrophil count and interleukin-6 were significantly associated with higher lethality. Conclusions. Itolizumab can disrupt the inflammatory cascade and might prevent the COVID-19 associated morbidity and mortality.
Palavras-chave : itolizumab; COVID-19; SARS-CoV-2; cytokine release syndrome; CD6; monoclonal antibody.