Infectious Disease

Anakinra lowers ventilation and the risk of death in non-intubated patients with COVID-19

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Milionis reports honoraria and non-financial support from Amgen, Angelini, Bayer, MSD, Pfizer, Sanofi and Servier. Please refer to the study for all relevant financial information from the other authors.

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Anakinra is sure to reduce the need for invasive mechanical ventilation and the risk of mortality in patients with COVID-19 who are hospitalized but not intubated, according to a meta-analysis published in Rheumatology.

“A subset of SARS-CoV-2 infected patients show hyperinflammatory symptoms that are similar to cytokine storm syndromes, which are characterized by an increased release of chemokines, growth factors and cytokines, including interleukins.” Haralampos Milionis, MD, PhD, from the University of Ioannina in Greece and colleagues wrote. “In this context, anakinra, an IL-1 receptor antagonist used to treat autoinflammatory diseases, has been considered in such patients.”

Anakinra reduces the need for invasive mechanical ventilation and the risk of mortality in patients admitted to hospital with COVID-19 but not intubated, according to a meta-analysis. Data derived from Barkas F, et al. Rheumatology. 2021; doi: 10.1093 / Rheumatologie / keab447.

“Previous reports have shown beneficial effects of anakinra in severe sepsis with inflammatory multi-organ dysfunction or secondary hemophagocytic lymphohistiocytosis, while case series and two recently published open-label studies have shown that treatment with anakinra can result in improved laboratory and clinical development in COVID-19. Hyperinflammation patients, ”they added.

To study the effectiveness and safety of anakinra (Kineret, SOBI) in hospitalized, non-intubated adults with COVID-19, Milionis and colleagues performed a systemic review and meta-analysis. Relevant studies were identified by a literature search for relevant terms – “anakinra”, “interleukin 1”, “coronavirus”, “COVID-19” and “SARS-CoV-2” – by April 24th.

Haralampos Millionis

Inclusion criteria were studies examining the effect of anakinra on the need for invasive mechanical ventilation and mortality in hospitalized, non-intubated patients with COVID-19. A total of nine studies with a total of 1,119 patients met the criteria and were included in the analysis.

According to the researchers, the risk of bias in the studies with regard to the assessed parameters was high. In the pooled analysis, however, anakinra reduced the need for invasive mechanical ventilation (OR = 0.38; 95% CI 0.17-0.85) and the mortality risk (OR = 0.32; 95% CI 0.23– 0.45) compared to standard therapy. In addition, there were no differences in the risk of adverse events, including liver dysfunction (OR = 0.75; 95% CI 0.48-1.16) and bacteremia (OR = 1.07; 95% CI, 0.42 – 2.73), between anakinra and standard therapy.

“Anakinra reduces the need for invasive mechanical ventilation and lowers the risk of death in non-intubated patients with COVID-19 in the hospital without increasing the risk of adverse events such as liver dysfunction or bacteremia,” Milionis told Healio Rheumatology.

“Given the noted shortage of ICU beds and the resulting increased exposure to medical wards during the current pandemic, the identification of therapeutic modalities to improve adverse outcomes and prevent ICU admission and death in this population group remains a public emergency Health, ”he added. “Therefore, our results are waiting to be confirmed by randomized, placebo-controlled studies.”

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COVID-19 and rheumatology

COVID-19 and rheumatology

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