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

Filgueira, Lázaro Manuel; Cervantes, Julio Betancourt; Lovelle, Orlando Adolfo; Herrera, Carlos; Figueredo, Carlos; Caballero, Jorge Alain; Sánchez, Naivy; Berrio, Jorge; Lorenzo, Geidy; Cepeda, Meylan; Ramos, Mayra; Saavedra, Danay; Añe-Kouri, Ana Laura; Mazorra, Zaima; Leon, Kalet; Crombet, Tania; Caballero, Armando

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.