Therapeutic use of specific tumour necrosis factor inhibitors in inflammatory diseases including COVID-19

Biomed Pharmacother. 2021 Aug;140:111785. doi: 10.1016/j.biopha.2021.111785.Epub 2021 May 28.

Serena Patel 1, Meenu Wadhwa 2


Author information

  • 1Downing College, Regent Street, Cambridge CB2 1DQ, UK; Ipswich Hospital, Heath Road, Ipswich IP4 5PD, UK.
  • 2NIBSC, MHRA, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK. Electronic address: Meenu.Wadhwa@nibsc.org.


Coronavirus disease 2019 (COVID-19) has caused significant devastation globally. Despite the development of several vaccines, with uncertainty around global uptake and vaccine efficacy, the need for effective therapeutic agents remains. Increased levels of cytokines including tumour necrosis factor are significant in the pathogenesis of COVID-19 and associated with poor outcomes including ventilator requirement and mortality. Repurposing tumour necrosis factor blocker therapy used in conditions such as rheumatoid arthritis and inflammatory bowel disease seems promising, with early feasibility data showing a reduction in circulation of pro-inflammatory cytokines and encouraging the evaluation of such interventions in preventing disease progression and clinical deterioration in patients with COVID-19. Here, we examine the biological activities of tumour necrosis factor inhibitors indicative of their potential in COVID-19 and briefly outline the randomised control trials assessing their benefit-risk profile in COVID-19 therapy.



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