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Effect of Interleukin 6 Receptor Antagonists in SARS-CoV-2 Patients

Completed
Conditions
Corona Virus Infection
Interventions
Diagnostic Test: ELISA
Registration Number
NCT05367882
Lead Sponsor
Assiut University
Brief Summary

1. Investigate the possible effects of interleukin-6 receptor antagonists such as tocilizumab and sarilumab on the levels of IL-6, inflammtory and anti-inflammtory markers and cytokines before and after treatment in critically ill corona virus disease-19 patients.

2. Correlate between IL-6 levels with other inflammatory markers as ferritin and C-reactive protein.

3. investigate the possible changes on the levels of other inflammatory, anti-inflammatory markers and cytokines such as IL-10 and IP-10, before and after treatment.

Detailed Description

An outbreak of a mutated respiratory virus that belongs to the Coronavirus family was reported in mid-December 2019, in Wuhan, China. The virus was named as severe acute respiratory syndrome coronavirus (SARS-CoV-2) and the disease was named as coronavirus disease-19 (COVID-19) by the WHO. The infection spread pandemically and by the end of October 2021,the number of confirmed cases of COVID-19 reached 244,897,472, including 4,970,435 deaths, reported by WHO. Viral genome was sequenced and published by public health information on 10th of January. COVID-19 uses the same cell entry receptor {Angiotensin converting enzyme II} (ACE2) as SARS-CoV . Recent studies have shown that IL-6 level increased in severe cases of COVID-19. IL-6 is one of the major pro-inflammatory factors that contribute to the formation of cytokine storm.Therefore, the IL-6 monoclonal antibody (mAb) directed COVID-19 therapy has been used in clinical trial in China. The main conclusion they reached was that the treatment with the IL-6 receptor antagonists ( tocilizumab (TCZ), sarilumab, sirukumab, olamkicept and levilimab) improved outcomes, including survival. TCZ is a humanized antibody that blocks both soluble and membrane-bound forms of IL-6 receptor. Sarilumab is a fully human antibody against the IL-6 receptor that binds to both soluble and membrane-bound IL-6 receptors and has the approval of the food and drug administration (FDA) for rheumatoid arthritis (RA) treatment. Additionally, these drugs have been considered for off-label use in the treatment of COVID-19.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
96
Inclusion Criteria
  • must be critically ill coronavirus disease-19
Exclusion Criteria
  • patients receiving corticosteroids
  • pregnancy
  • active TB
  • bacterial infection
  • fungal infection
  • co-infection with other hepatitis viruses.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
critically ill COVID-19 patients in ICUELISAcritically ill COVID-19 patients who are recommended to receive IL-6R antagonist as tocilizumab at the dosage of 8 mg/kg with a second dose 12 hours after the first dosage, or sarilumab at the dosage of 200 mg subcutaneously or 200 to 800 mg intravenously.
Primary Outcome Measures
NameTimeMethod
interleukin-10 levelsduring one year

measuring the levels of interleukin-10 in serum of patients before and after treatment

inflammatory markersduring one year

measuring the levels of some inflammatory markers in serum patients

interferon gamma inducible protein-10 levelsduring one year

measuring the levels of IP-10 in serum of patients before and after treatment

interleukin-6 levelsduring one year

Measuring the levels of interleukin-6 in serum of patients.

anti-inflammatory markersduring one year

measuring the levels of some anti-inflammatory markers in serum of patients before and after treatment

Secondary Outcome Measures
NameTimeMethod
survivalduring one year

Calculation of the possible correlation between the variation in interleukin-6 levels and different clinical and laboratory parameters including patient's survival and hospital stay.

Trial Locations

Locations (1)

AssiutU

🇪🇬

Assiut, Egypt

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