tetano
Editor, Senior Moderator
Infect Chemother
. 2021 Jun;53(2):221-237.
doi: 10.3947/ic.2021.0016.
The Safety and Efficacy of Anakinra, an Interleukin-1 Antagonist in Severe Cases of COVID-19: A Systematic Review and Meta-Analysis
Manoj Kumar Reddy Somagutta[SUP] 1 2 [/SUP], Maria Kezia Lourdes Pormento[SUP] 1 [/SUP], Pousette Hamid[SUP] 3 [/SUP], Alaa Hamdan[SUP] 1 [/SUP], Muhammad Adnan Khan[SUP] 1 [/SUP], Rockeven Desir[SUP] 1 [/SUP], Rupalakshmi Vijayan[SUP] 1 [/SUP], Saloni Shirke[SUP] 1 [/SUP], Rishan Jeyakumar[SUP] 1 [/SUP], Zeryab Dogar[SUP] 1 [/SUP], Sarabjot Singh Makkar[SUP] 1 [/SUP], Prathima Guntipalli[SUP] 1 [/SUP], Ngaba Neguemadji Ngardig[SUP] 1 [/SUP], Manasa Sindhura Nagineni[SUP] 1 [/SUP], Trissa Paul[SUP] 1 [/SUP], Enkhmaa Luvsannyam[SUP] 1 [/SUP], Chala Riddick[SUP] 1 [/SUP], Marcos A Sanchez-Gonzalez[SUP] 1 [/SUP]
Affiliations
Abstract
This study aims to assess anakinra's safety and efficacy for treating severe coronavirus disease 2019 (COVID-19). Numerous electronic databases were searched and finally 15 studies with a total of 3,530 patients, 757 in the anakinra arm, 1,685 in the control arm were included. The pooled adjusted odds ratio (OR) for mortality in the treatment arm was 0.34 (95% confidence interval [CI], 0.21 - 0.54, I² = 48%), indicating a significant association between anakinra and mortality. A significant association was found regarding mechanical ventilation requirements in anakinra group compared to the control group OR, 0.68 (95% CI, 0.49 - 0.95, I² = 50%). For the safety of anakinra, we evaluated thromboembolism risk and liver transaminases elevation. Thromboembolism risk was OR, 1.59 (95% CI, 0.65 - 3.91, I² = 0%) and elevation in liver transaminases with OR was 1.35 (95% CI, 0.61 - 3.03, I² = 76%). Both were not statistically significant over the control group. Anakinra is beneficial in lowering mortality in COVID-19 patients. However, these non-significant differences in the safety profile between the anakinra and control groups may have been the result of baseline characteristics of the intervention group, and further studies are essential in evaluating anakinra's safety profile.
Keywords: Anakinra; COVID-19; IL-1 antagonist; Kineret; SARS-CoV-2.
. 2021 Jun;53(2):221-237.
doi: 10.3947/ic.2021.0016.
The Safety and Efficacy of Anakinra, an Interleukin-1 Antagonist in Severe Cases of COVID-19: A Systematic Review and Meta-Analysis
Manoj Kumar Reddy Somagutta[SUP] 1 2 [/SUP], Maria Kezia Lourdes Pormento[SUP] 1 [/SUP], Pousette Hamid[SUP] 3 [/SUP], Alaa Hamdan[SUP] 1 [/SUP], Muhammad Adnan Khan[SUP] 1 [/SUP], Rockeven Desir[SUP] 1 [/SUP], Rupalakshmi Vijayan[SUP] 1 [/SUP], Saloni Shirke[SUP] 1 [/SUP], Rishan Jeyakumar[SUP] 1 [/SUP], Zeryab Dogar[SUP] 1 [/SUP], Sarabjot Singh Makkar[SUP] 1 [/SUP], Prathima Guntipalli[SUP] 1 [/SUP], Ngaba Neguemadji Ngardig[SUP] 1 [/SUP], Manasa Sindhura Nagineni[SUP] 1 [/SUP], Trissa Paul[SUP] 1 [/SUP], Enkhmaa Luvsannyam[SUP] 1 [/SUP], Chala Riddick[SUP] 1 [/SUP], Marcos A Sanchez-Gonzalez[SUP] 1 [/SUP]
Affiliations
- PMID: 34216117
- DOI: 10.3947/ic.2021.0016
Abstract
This study aims to assess anakinra's safety and efficacy for treating severe coronavirus disease 2019 (COVID-19). Numerous electronic databases were searched and finally 15 studies with a total of 3,530 patients, 757 in the anakinra arm, 1,685 in the control arm were included. The pooled adjusted odds ratio (OR) for mortality in the treatment arm was 0.34 (95% confidence interval [CI], 0.21 - 0.54, I² = 48%), indicating a significant association between anakinra and mortality. A significant association was found regarding mechanical ventilation requirements in anakinra group compared to the control group OR, 0.68 (95% CI, 0.49 - 0.95, I² = 50%). For the safety of anakinra, we evaluated thromboembolism risk and liver transaminases elevation. Thromboembolism risk was OR, 1.59 (95% CI, 0.65 - 3.91, I² = 0%) and elevation in liver transaminases with OR was 1.35 (95% CI, 0.61 - 3.03, I² = 76%). Both were not statistically significant over the control group. Anakinra is beneficial in lowering mortality in COVID-19 patients. However, these non-significant differences in the safety profile between the anakinra and control groups may have been the result of baseline characteristics of the intervention group, and further studies are essential in evaluating anakinra's safety profile.
Keywords: Anakinra; COVID-19; IL-1 antagonist; Kineret; SARS-CoV-2.