Focus shifts to antibody cocktails for COVID-19 cytokine storm

24 Nov, 2020
Emerging clinical trial data suggest that individual immunomodulatory drugs can dampen the hyperactive immune system in severe COVID-19, but polytherapy is the way forward.

On June 5 the Ministry of Health of the Russian Federation registered Biocad’s Ilsira (levilimab) as a treatment for severe COVID-19. Ilsira is one of several monoclonal antibodies (mAbs) targeting interleukin-6 receptor (IL-6R) and a host of other inflammatory cytokines currently in clinical testing against coronavirus. As Nature Biotechnology went to press, peer-reviewed data assessing the efficacy of these treatments were limited: a small clinical study of Roche’s Actemra (tocilizumab, an mAb targeting IL-6R) and an open-label trial of Bermuda-based Kiniksa Pharmaceuticals’ mavrilimumab (a fully human IgG4 mAb targeting granulocyte–macrophage colony stimulating factor, GM-CSF). As clinicians await published data from a raft of other IL-6 and GM-CSF inhibitors in human testing, the need to combine agents targeting different cytokines is emerging as the likely path forward for supportive care for COVID-19 patients with acute respiratory distress syndrome.

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