Fostamatinib

How it works

Benefits

Risks & contraindications

Comparisons

Evidence quality

Highlighted claims

• Fostamatinib inhibits the SYK pathway, which is activated by C-type lectin receptors, C-type lectin-like receptors, and Fc receptors. — Multiarm multistage randomised controlled trial of inflammatory signal inhibitors (MATIS) for patients hospitalised with COVID-19 pneumonia during the UK pandemic
• SYK modulates cytokine secretion and promotes macrophage and monocyte influx into the lung, contributing to both the hyperinflammatory state and long-term lung damage. — Multiarm multistage randomised controlled trial of inflammatory signal inhibitors (MATIS) for patients hospitalised with COVID-19 pneumonia during the UK pandemic
• Fostamatinib caused a statistically significant elevation of serum creatinine compared with standard of care. — Multiarm multistage randomised controlled trial of inflammatory signal inhibitors (MATIS) for patients hospitalised with COVID-19 pneumonia during the UK pandemic
• The FOCUS trial, enrolling more severely ill patients, found that fostamatinib significantly reduced days on supplemental oxygen compared with placebo. — Multiarm multistage randomised controlled trial of inflammatory signal inhibitors (MATIS) for patients hospitalised with COVID-19 pneumonia during the UK pandemic
• Despite plausible biological rationale, MATIS found no benefit from fostamatinib, possibly because enrolled patients were too mildly ill, the dose was suboptimal, or the duration insufficient. — Multiarm multistage randomised controlled trial of inflammatory signal inhibitors (MATIS) for patients hospitalised with COVID-19 pneumonia during the UK pandemic
• Evidence from multiple trials suggests fostamatinib may confer greater benefit at more advanced disease stages. — Multiarm multistage randomised controlled trial of inflammatory signal inhibitors (MATIS) for patients hospitalised with COVID-19 pneumonia during the UK pandemic