Genetic validation of the use of tocilizumab, statins and dexamethasone in COVID-19
Abstract Background New means of treating COVID-19 are urgently needed. Genetic validation of drugs can foreshadow trial results, and help prioritize investigations. We assessed whether common drugs, suggested as possible treatments for COVID-19 (tocilizumab, anakinra and statins) with established genetic proxies, are effective in COVID-19. We also included dexamethasone as a positive control exposure because the RECOVERY trial suggested benefit in severe COVID-19.Methods We assessed, using Mendelian randomization, whether genetic proxies of tocilizumab, anakinra, statins and dexamethasone use affected risk of very severe (cases=536, non-cases=329391) or hospitalized (cases=3199, non-cases=897488) COVID-19 using a recent genome-wide association study.Results Using rs2228145 (IL6R) to proxy effects of tocilizumab use, no association with very severe COVID-19 was found, but possibly an inverse association with hospitalized COVID-19 (odds ratio (OR) 0.83 per standardized effect of higher soluble interleukin-6r, 95% confidence interval 0.67 to 1.02). Using rs12916 (HMGCR) to proxy effects of statins use, an inverse association with very severe COVID-19 was found (OR 0.30 per standardized effect, 95% CI 0.10 to 0.89). Using rs6743376 and rs1542176 to proxy effects of anakinra use, no associations with COVID-19 were found. Dexamethasone, instrumented by cortisol, was possibly inversely associated with very severe COVID-19 (OR 0.20 per standardized effect 95% CI 0.04 to 1.04).Conclusion Our study provides some genetic validation for the use of both tocilizumab and statins in COVID-19, but not anakinra, whilst being consistent with the findings from the RECOVERY trial about dexamethasone. Investigation of the underlying mechanisms might facilitate re-purposing and development of effective treatments..
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Preprint| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
bioRxiv.org - (2021) vom: 15. Jan. Zur Gesamtaufnahme - year:2021 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Schooling, CM [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.1101/2020.07.09.20149450 |
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| PPN (Katalog-ID): |
XBI01836022X |
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| 520 | |a Abstract Background New means of treating COVID-19 are urgently needed. Genetic validation of drugs can foreshadow trial results, and help prioritize investigations. We assessed whether common drugs, suggested as possible treatments for COVID-19 (tocilizumab, anakinra and statins) with established genetic proxies, are effective in COVID-19. We also included dexamethasone as a positive control exposure because the RECOVERY trial suggested benefit in severe COVID-19.Methods We assessed, using Mendelian randomization, whether genetic proxies of tocilizumab, anakinra, statins and dexamethasone use affected risk of very severe (cases=536, non-cases=329391) or hospitalized (cases=3199, non-cases=897488) COVID-19 using a recent genome-wide association study.Results Using rs2228145 (IL6R) to proxy effects of tocilizumab use, no association with very severe COVID-19 was found, but possibly an inverse association with hospitalized COVID-19 (odds ratio (OR) 0.83 per standardized effect of higher soluble interleukin-6r, 95% confidence interval 0.67 to 1.02). Using rs12916 (HMGCR) to proxy effects of statins use, an inverse association with very severe COVID-19 was found (OR 0.30 per standardized effect, 95% CI 0.10 to 0.89). Using rs6743376 and rs1542176 to proxy effects of anakinra use, no associations with COVID-19 were found. Dexamethasone, instrumented by cortisol, was possibly inversely associated with very severe COVID-19 (OR 0.20 per standardized effect 95% CI 0.04 to 1.04).Conclusion Our study provides some genetic validation for the use of both tocilizumab and statins in COVID-19, but not anakinra, whilst being consistent with the findings from the RECOVERY trial about dexamethasone. Investigation of the underlying mechanisms might facilitate re-purposing and development of effective treatments. | ||
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| 700 | 1 | |a Kwok, MK |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, JV |e verfasserin |4 aut | |
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