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10.1111/bcp.15009

http://scihub22266oqcxt.onion/10.1111/bcp.15009
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34318516!8444890!34318516
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suck abstract from ncbi


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pmid34318516      Br+J+Clin+Pharmacol 2022 ; 88 (3): 1043-1053
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  • COVID-19 acute respiratory distress syndrome: A simulation study of the effects of combination therapy with tocilizumab and siltuximab #MMPMID34318516
  • Doyle EB; Bentley D; Dodds MG
  • Br J Clin Pharmacol 2022[Mar]; 88 (3): 1043-1053 PMID34318516show ga
  • AIMS: To assess the potential of interleukin-6 (IL-6) signalling blockade in the lung to treat SARS-CoV-2 infection via model-based simulation by exploring soluble IL-6 receptor (sIL-6R) sequestration by tocilizumab (TCZ) and IL-6 sequestration by siltuximab (SIL). METHODS: Literature values of IL-6, IL-6 antagonist SIL, sIL-6R, IL-6R antagonist TCZ and their respective binding constants were used to develop a model to predict the impact of treatment on IL-6 signalling. Models were used to generate simulated bronchoalveolar lavage fluid concentrations for normal subjects, subjects at risk of developing acute respiratory distress syndrome (ARDS), and subjects with ARDS under 4 conditions: without treatment; treatment with TCZ; treatment with SIL; and treatment with TCZ + SIL. RESULTS: With TCZ intervention, IL-6 levels are unaffected and sIL-6R is reduced somewhat below the Normal case. IL-6:sIL-6R complex only slightly decreased relative to the no-intervention case. With SIL intervention, sIL-6R levels are unaffected and IL-6 is greatly reduced below the Normal case. IL-6:sIL-6R complex is greatly decreased relative to the no-intervention case. With TCZ + SIL intervention, IL-6 and sIL-6R levels are reduced below the Normal case and achieve suppression equivalent to monotherapy results for their respective targets. IL-6:sIL-6R complex reduction is predicted to be greater than that achieved with monotherapy. This reflects sequestration of both components of the complex and the nonlinear binding equilibrium. CONCLUSION: Coadministration of both IL-6 and IL-6R sequestering products such as SIL and TCZ may be necessary to effectively treat COVID-19 patients who have or are at risk of developing ARDS.
  • |*COVID-19 Drug Treatment[MESH]
  • |*Respiratory Distress Syndrome/drug therapy/virology[MESH]
  • |Antibodies, Monoclonal, Humanized/*therapeutic use[MESH]
  • |Antibodies, Monoclonal/*therapeutic use[MESH]
  • |Computer Simulation[MESH]
  • |Drug Therapy, Combination[MESH]
  • |Humans[MESH]


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