Table 2.
Drugs | Antiviral mechanisms | Rheumatic musculoskeletal adverse events | Refs. |
---|---|---|---|
Chloroquine and hydroxychloroquine | Inhibit pH-dependent internalization and fusion of the virus with lysosomes | Myopathy and neuromyopathy | [33] |
Favipiravir | Inhibit viral RNA-dependent RNA polymerase | Hyperuricemia | [34] |
Remdesivir | Not reported | ||
EIDD-2801 | Not reported | ||
Lopinavir-ritonavir | Protease inhibitor | Hyperuricemia (≤ 5%), musculoskeletal pain (6%), arthralgia (< 2%), osteonecrosis, vasculitis, SJS-TEN | [35] |
Umifenovir | Block the virus-cell membrane fusion as well as virus-endosome fusion | Not reported | |
Galidesivir | Antiviral adenosine nucleoside analog | Not reported | |
Ribavirin | Interfere with polymerases, RNA capping, and inosine monophosphate dehydrogenase |
Arthralgia (> 10%), musculoskeletal pain (> 10%), backache (1–10%), gout (< 1%), myositis (< 1%), Exacerbation of sarcoidosis (higher incidence in combination with interferon α) |
[36] |
Camostat mesylate | Serine protease inhibitor | Not reported | |
Interferon α and β | Inhibit replication |
Interferon α2b: Myalgia (16–75%), musculoskeletal pain (1–21%), arthralgia (3–19%), backache (1–19%), amyotrophy (< 5%), Arthritis (< 5%) including RA, Other autoimmune disease (< 1%) including sarcoidosis, myositis, rhabdomyolysis, SJS, SLE, vasculitis Interferon β1a and β1b: Myalgia (25–29%), Backache (23–25%), Autoimmune hepatitis, Immune thrombocytopenia, SLE, osteonecrosis, Sjogren syndrome |
[37] |
Convalescent plasma |
Chance of transfusion-related adverse events: urticaria, anaphylaxis, transfusion-related acute lung injury Latent risk of hyperimmune attacks: Possibly via antibody-dependent enhancement of tissue damage and blunting of endogenous immunity to the virus |
RNA ribonucleic acid, SJS-TEN Steven Johnson syndrome-toxic epidermal necrolysis, SLE systemic lupus erythematosus