Table 2.
Classification, Mechanism of action, adverse effects and therapeutic uses of Anti-inflammatory &Immunomodulatory agents against COVID-19.
| Name of Drug(s) | Classification | Mechanism of action | Adverse effects | Therapeutic Uses | Safety Concern |
|---|---|---|---|---|---|
| Chloroquine/Hydroxy-chloroquine (HCQ) | 4-aminoquinolones | Inhibit viral DNA & RNA polymerase enzyme, viral protein glycosylation, ACE2 receptor, also inhibit cytokine release immune-modulation | Cardiovascular symptoms (prolongation of QT interval) | Antimalarial, Immuno-modulator | Cautiously used in liver & heart damage, GIT, retinal, neurological & hematological diseases |
| Anakinra | Biological agents | Recombinant human IL-1 receptor antagonist | Fever, chills, sweating, cough, sore throat, nausea, vomiting, diarrhea, stomach pain | Refractory rheumatoid arthritis | Caution in patients with thrombocytopenia & neutropenia, infusion related reactions |
| Canakinumab (ACZ885) | Human monoclonal antibody | IL-1β receptor antagonist | CNS (headache, vertigo), GI symptoms, musculoskeletal pain, rhinitis, bronchitis | Periodic fever syndromes, Sudden Juvenile Idiopathic Arthritis (SJIA) | Caution in patients with thrombocytopenia & neutropenia |
| Tocilizumab/Itolizumab | Humanized monoclonal antibody | IL-6 receptor antagonist | Allergic reactions, headache, hypertension, mouth ulcers, increase in hepatic enzymes | Autoimmune disorder/immunosuppressive effects (rheumatoid arthritis, giant cell arteritis) | Contraindicated in hepatic diseases, GIT perforation patients, infusion related reactions |
| Aviptadil | Vasoactive intestinal polypeptide (VIP) analogue | Inhibits production ofIL-6 and TNF-α | Alterations in blood pressure, Heart rate | Erectile dysfunction, sarcoidosis, acute lung damage | Cautiously used in cardiovascular patients |
| Eculizumab | Protein Based Therapies Monoclonal antibody (mAb) |
Inhibitor of the terminal portion of complement cascade | Allergic reactions, anemia, GIT & flu like symptoms, headache & leukopenia | Atypical hemolytic uremic syndrome, generalized myasthenia gravis | Contraindicated in patients with unresolved serious Neisseria meningitides infection |
| Baricitinib | Tyrosine protein kinase family | Janus-kinase (JAK1 & JAK 2) inhibitors | Allergic reactions, increased LDL cholesterol, nausea, trouble in breathing | Autoimmune disease (rheumatoid arthritis) | Contraindicated in kidney and liver diseases (hepatic B&C), bone-marrow depression and cancer |