"Circulating cytokines" are indirect measures of inflammation.
The therapy may reduce them, but not lead to changes in clinical outcomes.
This is why, as an outcome, these are not very important.
For example, we use serum white cell counts as a marker of inflammation. Treating someone with steroids often causes these to increase, despite steroids actually decreasing inflammation. The mechanism is more complex than I would like to go into.
But if you looked just at the inflammatory marker you'd assume steroids worsened inflammation.
Ann: Mesoblast Update on COVID-19 ARDS Trial, page-348
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