Desogestrel and Ethinyl Estradiol Tablets (Pimtrea)- FDA

Desogestrel and Ethinyl Estradiol Tablets (Pimtrea)- FDA opinion

CS is characterized by a clinical presentation of overwhelming systemic inflammation, hyperferritinemia, hemodynamic instability, and multi-organ failure, and if left untreated, it leads to death. The trigger for CS is an uncontrolled immune response resulting in continuous activation and grape oil seed of immune cells, lymphocytes, and macrophages, which produce immense amounts of cytokines, resulting in Desogestrel and Ethinyl Estradiol Tablets (Pimtrea)- FDA cytokine storm.

Both pro-inflammatory cytokines (e. In the absence of an immediate and appropriate therapeutic intervention, patients develop ARDS as a result of acute lung damage followed by multi-organ failure and resulting in death. Hence, the CS should be treated immediately, otherwise mortality can result (28). In addition to anti-viral therapies that can directly target the virus, anti-inflammatory therapies that diminish the cytokine responses are suggested to decrease both the morbidity and mortality in COVID-19 patients.

The early recognition of CS and the prompt treatment can lead to better outcome. Several biological agents targeting cytokines have been proposed for treating CS. IL-1 receptor antagonist, anakinra, which is used in treatment of rheumatoid arthritis, was Desogestrel and Ethinyl Estradiol Tablets (Pimtrea)- FDA to be helpful in cytophagic histiocytic panniculitis with secondary hemophagocytic lymphohistiocytosis, a disease associated with severe CS (33).

Tocilizumab is a recombinant humanized IL-6 receptor antagonist that interferes with IL-6 binding to its receptor and blocks signaling. Tocilizumab is used in treatment of rheumatoid arthritis, juvenile idiopathic arthritis, giant cell arteritis, and has proven valuable in treatment of CS triggered sex laif CAR-T cell therapy for hematological malignancies (34).

Downstream inhibitors of cytokines, e. As IL-6 is the most frequently reported cytokine to be increased in COVID-19 patients and as IL-6 elevated levels have been associated to higher mortalities, tocilizumab is a candidate drug to be used in managing the cytokine storm accompanying COVID-19.

Encouraging results have been reported in China where tocilizumab was used in treatment of 21 patients with severe and critical COVID-19. Clinical data showed that the symptoms, hypoxygenmia, and CT opacity changes were improved immediately after the treatment with tocilizumab in most of the patients, suggesting that tocilizumab could be an efficient therapeutic agent for treatment of the cytokine storm associated with COVID-19 (35). The US Food and Drug Administration (FDA) has Desogestrel and Ethinyl Estradiol Tablets (Pimtrea)- FDA Roche's Phase III clinical trial of the use of tocilizumab in hospitalized patients with severe COVID-19 pneumonia.

The trial is planned to include 330 patients with severe COVID-19 pneumonia (36). Cytokine storm appears to be one of the common causes of mortality in the recently 7 weeks pandemic of COVID-19.

Therapeutic approaches to manage the COVID-19 cytokine storm might provide an avenue to decrease the COVID-19 associated morbidity and mortality and is the focus of upcoming studies.

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Neutrophil-to-lymphocyte ratio as an independent risk factor for maortality in hospitalized patients with COVID-19.

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