A small sample of patients (n = 8, mean age = 62) received two 200 mg doses of Sarilumab with their daily doses of hydroxychloroquine (400 mg), azithromycin (500 mg), darunavir (800 mg), cobicistat (150 mg), and enoxaparin (100 U/kg). Respiratory function improved to reduce 30% of oxygen demand, and 7 of 8 patients were discharged within 14 days (the other patient passed away in 13 days after hospitalization). This report is merely an observational study and features no controls.

Outcomes among 8 patients at Hospital San Giovanni di Dio in Florence, Italy

Sarilumab is a competitive inhibitor of Interleukin-6 (IL-6) through its action as a anti-IL-6 receptor monoclonal antibody. Like tocilizumab, it can inhibit both the cis and trans transduction pathways of IL-6 signaling since it can inhibit both membrane-bound and soluble IL-6 receptors. However, sarilumab has a higher affinity than tocilizumab.

- Outcomes among 8 patients at Hospital San Giovanni di Dio in Florence, Italy

Boston University

The IL-6 receptor is a proposed target for treatment because IL-6 is responsible for inducing the cytokine storm. Tocilizumab is an anti-IL-6 receptor antibody used to treat certain forms of arthritis. In China, it has been demonstrated to reduce fever and improve respiratory function in patients with severe COVID-19. Sarilumab is another anti-IL-6 receptor antibody treatment option that binds and blocks IL-6 recptors.

Blocking IL-6 Signaling 

Abdin, S. M., Elgendy, S. M., Alyammahi, S. K., Alhamad, Omar, H. A. (2020). Tackling the cytokine storm in COVID-19, challenges and hopes. https://www.sciencedirect.com/science/article/pii/S0024320520308055

Tackling the cytokine storm in COVID-19, challenges and hopes

Tocilizumab inhibits Interleukin-6 (IL-6) which may mitigate the extreme inflammatory response among COVID-19 patients. 

- Outcomes among 100 severe COVID-19 patients in Brescia, Italy during 10-day follow-up after Tocilizumab infusion

- Figure illustrating how Tocilizumab calms the inflammatory storm by blocking IL-6 receptors

- Severe COVID-19 cases and the impact of tocilizumab

- Toxicities of TCZ

- Tocilizumab among patients with COVID-19 in the intensive care unit: a multicentre observational study

- Case Report of Tocilizumab for COVID-19 Pneumonia in a Non Small Cell Lung Cancer Patient Treated with Chemo-Immunotherapy

- Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state

Tocilizumab (TCZ) As a Treatment for COVID-19

Siltuximab is an inhibitor of soluble IL-6 receptors via its action as a chimeric human-mouse monoclonal antibody. It has been approved for the treatment of multicentric Castleman disease.

- Outcomes among 30 patients at Azienda Socio Sanitario Territoriale Papa Giovanni XXIII Hospital in Bergamo, Italy

Siltuximab as a Treatment for COVID-19

Sarilumab as a Treatment for COVID-19

Aged garlic extract increased IL-10 In peripheral blood monocytes by inhibiting TNF-a and IL-6, which are inflammatory cytokines that play a key role in the pathogenesis of SARS-CoV-2. 

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