Remicade (infliximab) and Humira (adalimumab) are the established anti-tumour necrosis factor (TNF) therapies that have been shown to decrease inflammation in diseases such as rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). As these anti-TNF therapies reduce inflammation, they could treat COVID-19 patients with acute respiratory distress (ARDS), says GlobalData, a data and analytics company.

This would reduce COVID-19 mortality, as about 17 of COVID-19 patients develop ARDS.

Patrick Aiyes, MEng, Senior Healthcare Analyst at GlobalData, comments, “Currently, there are no pharma companies testing TNF inhibitors in patients with COVID-19; this could be an opportunity to explore, given the pressing need for treatments for COVID-19. The proposed patient group for anti-TNF therapy would be those in a clinical trial setting with moderate diseases and requiring oxygen support but not admitted to intensive care.”

Although anti-TNF therapy could be useful clinically, it is possible that it may not outweigh the cost-benefit ratio, given that in diseases such as ulcerative colitis (UC), the annual cost of therapy can range from $11,000–14,000 in the UK.”

Aiyes concludes, “Although in theory, anti-TNF therapy could be beneficial in treating COVID-19, concerns surrounding the drug class’ safety profile remain. In COVID-19 patients, there is some evidence that bacterial infections could develop faster in a damaged lung and anti-TNF therapy could increase the risk of that infection due to its effects on a patient’s inflammatory response.

“There are preclinical studies in mice that demonstrate that anti-TNF therapy improves symptoms of influenza and respiratory syncytial virus (RSV). In RA patients, blocking TNF reduces cytokine concentrations. This indicates that anti-TNFs in COVID-19 patients could prove beneficial.”