Morrison AR, Johnson JM, Ramesh M, Bradley P, Jennings J, and Smith ZR. Letter to the Editor: Acute hypertriglyceridemia in patients with COVID-19 receiving tocilizumab. J Med Virol 2020.
Journal of medical virology
Tocilizumab is an interleukin-6 (IL-6) receptor antibody and is progressing as a viable and promising treatment option in patients with severe coronavirus disease 2019 (COVID-19). IL-6 is known to have both immunomodulatory and metabolic actions. In this letter we outline two cases of acute hypertriglyceridemia in patients with COVID-19 treated with tocilizumab: one with elevated biomarkers consistent with acute pancreatitis the other without. Given the paucity of robust clinical trial data for most COVID-19 pharmacotherapies at this time, clinicians should continue to remain steadfast in recognition of interventions that improve clinical outcomes and vigilant in monitoring for acute adverse effects that are difficult to detect in clinical trials with small sample sizes. The observations from our two cases highlight the complex, not fully elucidated interrelationship between elevated IL-6 and pharmacologic interventions impacting this pathway. Clinicians should consider monitoring for hypertriglyceridemia and acute pancreatitis as described with chronic tocilizumab use for rheumatoid arthritis in those receiving it for COVID-19.
ePub ahead of print