An anti-CD6 antibody for the treatment of COVID-19 patients with cytokine-release syndrome: report of three cases

Immunotherapy. 2021 Mar;13(4):289-295. doi: 10.2217/imt-2020-0235. Epub 2021 Jan 5.

Abstract

In COVID-19, the inflammatory cytokine-release syndrome is associated with the progression of the disease. Itolizumab is a monoclonal antibody that recognizes human CD6 expressed in activated T cells. The antibody has shown to be safe and efficacious in the treatment of moderate to severe psoriasis. Its effect is associated with the reduction of pro-inflammatory cytokines release, including IFN-γ, IL-6 and TNF-α. Here, we report the outcome of three severe and critically ill COVID-19 patients treated with itolizumab as part of an expanded access protocol. Itolizumab was able to reduce IL-6 concentrations in all the patients. Two of the three patients showed respiratory and radiological improvement and were fully recovered. We hypothesize this anti-inflammatory therapy in addition to antiviral and anticoagulant therapy could reduce COVID-19 associated morbidity and mortality.

Keywords: CD6 molecule; COVID-19; IL-6; SARS-CoV-2; coronavirus 2; cytokine-release syndrome; itolizumab; monoclonal antibody.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antigens, CD / immunology*
  • Antigens, Differentiation, T-Lymphocyte / immunology*
  • Biomarkers / blood
  • COVID-19 / pathology
  • COVID-19 Drug Treatment*
  • Critical Illness
  • Cytokine Release Syndrome / drug therapy*
  • Cytokine Release Syndrome / pathology
  • Drug Therapy, Combination
  • Female
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Antigens, CD
  • Antigens, Differentiation, T-Lymphocyte
  • Biomarkers
  • CD6 antigen
  • Interleukin-6
  • itolizumab