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Immunomodulators

Last Updated: April 20, 2023

Summary Recommendations
Summary Recommendations
  • The hyperactive inflammatory response to SARS-CoV-2 infection plays a central role in the pathogenesis of COVID-19. See Therapeutic Management of Hospitalized Adults With COVID-19 and Therapeutic Management of Hospitalized Children With COVID-19 for the COVID-19 Treatment Guidelines Panel’s (the Panel) recommendations on the use of the following immunomodulators for hospitalized patients according to disease severity:
    • Corticosteroid: dexamethasone
    • Interleukin-6 inhibitor: tocilizumab (or sarilumab)
    • Janus kinase inhibitor: baricitinib (or tofacitinib)
  • There is insufficient evidence for the Panel to recommend either for or against the use of the following immunomodulators for the treatment of COVID-19:
    • Anakinra
    • Inhaled corticosteroids
  • The Panel recommends against the use of canakinumab for the treatment of COVID-19, except in a clinical trial (BIIa).
Each recommendation in the Guidelines receives a rating for the strength of the recommendation (A, B, or C) and a rating for the evidence that supports it (I, IIa, IIb, or III). See Guidelines Development for more information.

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