tetano
Editor, Senior Moderator
Immun Inflamm Dis
. 2021 Nov 11.
doi: 10.1002/iid3.563. Online ahead of print.
A randomized controlled clinical trial on efficacy and safety of anakinra in patients with severe COVID-19
Amir Behnam Kharazmi[SUP] 1 [/SUP], Omid Moradi[SUP] 2 [/SUP], Mehrdad Haghighi[SUP] 3 4 [/SUP], Mehran Kouchek[SUP] 5 [/SUP], Alireza Manafi-Rasi[SUP] 6 [/SUP], Masoomeh Raoufi[SUP] 7 [/SUP], Simin Dokht Shoaei[SUP] 3 4 [/SUP], Fahimeh Hadavand[SUP] 3 4 [/SUP], Mahmood Nabavi[SUP] 3 4 [/SUP], Mir Mohammad Miri[SUP] 5 [/SUP], Sara Salarian[SUP] 5 [/SUP], Seyedpouzhia Shojaei[SUP] 5 [/SUP], Shayesteh Khalili[SUP] 1 [/SUP], Mohammad Sistanizad[SUP] 2 8 [/SUP], Setayesh Sadeghi[SUP] 9 [/SUP], Amirhossein Karagah[SUP] 2 [/SUP], Saemeh Asgari[SUP] 10 [/SUP], Morteza Jaffaraghaei[SUP] 11 [/SUP], Shahram Araghi[SUP] 12 [/SUP]
Affiliations
Abstract
Introduction: Hyperinflammatory state has a role in the pathogenesis of COVID-19. Anakinra could reduce inflammation and help to combat the condition. In this study, we aimed to assess the safety and efficacy of anakinra (PerkinRA®) in severe COVID-19.
Method: The study was an open-label, randomized, controlled trial conducted in Imam Hossein Medical Center from May to July 2020. Patients with a confirmed diagnosis of COVID-19 were included in this study. We administered anakinra 100 mg daily intravenously. All patients received COVID-19 pharmacotherapy based on the represented national guideline. The need for invasive mechanical ventilation is considered the primary outcome.
Results: Thirty patients were included in this study, and 15 of them received Anakinra. Nineteen patients were male (63.3%), and 11 were female (36.7%). The mean age of patients was 55.77 ± 15.89 years. In the intervention group, the need for invasive mechanical ventilation was significantly reduced compared to the control group (20.0% vs. 66.7%, p = .010). Also, these patients had a significantly lower length of hospital stay (p = .043). No significant higher rate of infection was recorded.
Conclusion: Anakinra as an immunomodulatory agent has been associated with the reduced need for mechanical ventilation in patients admitted to intensive care units because of severe COVID-19. The medication reduced the hospital length of stay. Furthermore, no increased risk of infection was observed. Further randomized placebo-controlled trials with a larger sample size are needed to confirm these findings.
Keywords: COVID-19; acute respiratory distress syndrome; anakinra; coronavirus; inflammation; interleukin-1 inhibitor; mortality.
. 2021 Nov 11.
doi: 10.1002/iid3.563. Online ahead of print.
A randomized controlled clinical trial on efficacy and safety of anakinra in patients with severe COVID-19
Amir Behnam Kharazmi[SUP] 1 [/SUP], Omid Moradi[SUP] 2 [/SUP], Mehrdad Haghighi[SUP] 3 4 [/SUP], Mehran Kouchek[SUP] 5 [/SUP], Alireza Manafi-Rasi[SUP] 6 [/SUP], Masoomeh Raoufi[SUP] 7 [/SUP], Simin Dokht Shoaei[SUP] 3 4 [/SUP], Fahimeh Hadavand[SUP] 3 4 [/SUP], Mahmood Nabavi[SUP] 3 4 [/SUP], Mir Mohammad Miri[SUP] 5 [/SUP], Sara Salarian[SUP] 5 [/SUP], Seyedpouzhia Shojaei[SUP] 5 [/SUP], Shayesteh Khalili[SUP] 1 [/SUP], Mohammad Sistanizad[SUP] 2 8 [/SUP], Setayesh Sadeghi[SUP] 9 [/SUP], Amirhossein Karagah[SUP] 2 [/SUP], Saemeh Asgari[SUP] 10 [/SUP], Morteza Jaffaraghaei[SUP] 11 [/SUP], Shahram Araghi[SUP] 12 [/SUP]
Affiliations
- PMID: 34762351
- DOI: 10.1002/iid3.563
Abstract
Introduction: Hyperinflammatory state has a role in the pathogenesis of COVID-19. Anakinra could reduce inflammation and help to combat the condition. In this study, we aimed to assess the safety and efficacy of anakinra (PerkinRA®) in severe COVID-19.
Method: The study was an open-label, randomized, controlled trial conducted in Imam Hossein Medical Center from May to July 2020. Patients with a confirmed diagnosis of COVID-19 were included in this study. We administered anakinra 100 mg daily intravenously. All patients received COVID-19 pharmacotherapy based on the represented national guideline. The need for invasive mechanical ventilation is considered the primary outcome.
Results: Thirty patients were included in this study, and 15 of them received Anakinra. Nineteen patients were male (63.3%), and 11 were female (36.7%). The mean age of patients was 55.77 ± 15.89 years. In the intervention group, the need for invasive mechanical ventilation was significantly reduced compared to the control group (20.0% vs. 66.7%, p = .010). Also, these patients had a significantly lower length of hospital stay (p = .043). No significant higher rate of infection was recorded.
Conclusion: Anakinra as an immunomodulatory agent has been associated with the reduced need for mechanical ventilation in patients admitted to intensive care units because of severe COVID-19. The medication reduced the hospital length of stay. Furthermore, no increased risk of infection was observed. Further randomized placebo-controlled trials with a larger sample size are needed to confirm these findings.
Keywords: COVID-19; acute respiratory distress syndrome; anakinra; coronavirus; inflammation; interleukin-1 inhibitor; mortality.