tetano
Editor, Senior Moderator
J Immunol
. 2021 Feb 5;ji2001126.
doi: 10.4049/jimmunol.2001126. Online ahead of print.
IL-1 Receptor Antagonist Anakinra in the Treatment of COVID-19 Acute Respiratory Distress Syndrome: A Retrospective, Observational Study
Marco Franzetti[SUP] 1 [/SUP], Andrea Forastieri[SUP] 2 [/SUP], Noemi Borsa[SUP] 3 [/SUP], Alessandro Pandolfo[SUP] 4 [/SUP], Chiara Molteni[SUP] 4 [/SUP], Luca Borghesi[SUP] 4 [/SUP], Silvia Pontiggia[SUP] 4 [/SUP], Giulia Evasi[SUP] 2 [/SUP], Lorenzo Guiotto[SUP] 2 [/SUP], Mattia Erba[SUP] 2 [/SUP], Ugo Pozzetti[SUP] 5 [/SUP], Anna Ronchetti[SUP] 5 [/SUP], Letizia Valsecchi[SUP] 4 [/SUP], Gioacchino Castaldo[SUP] 4 [/SUP], Ernesto Longoni[SUP] 4 [/SUP], Daniele Colombo[SUP] 3 [/SUP], Marco Soncini[SUP] 5 [/SUP], Stefano Crespi[SUP] 6 [/SUP], Stefano Maggiolini[SUP] 7 [/SUP], Davide Guzzon[SUP] 8 [/SUP], Stefania Piconi[SUP] 4 [/SUP]
Affiliations
Abstract
The IL-1 receptor antagonist, anakinra, may represent a therapeutic option for acute respiratory distress syndrome (ARDS) associated with coronavirus disease 2019 (COVID-19). In this study, COVID-19 ARDS patients admitted to the Azienda Socio Sanitaria Territoriale of Lecco, Italy, between March 5th to April 15th, 2020, and who had received anakinra off-label were retrospectively evaluated and compared with a cohort of matched controls who did not receive immunomodulatory treatment. The primary end point was survival at day 28. The population consisted of 112 patients (56 treated with anakinra and 56 controls). Survival at day 28 was obtained in 69 patients (61.6%) and was significantly higher in anakinra-treated patients than in the controls (75.0 versus 48.2%, p = 0.007). When stratified by continuous positive airway pressure support at baseline, anakinra-treated patients' survival was also significant compared with the controls (p = 0.008). Univariate analysis identified anakinra usage (odds ratio, 3.2; 95% confidence interval, 1.47-7.17) as a significant survival predictor. This was not supported by multivariate modeling. The rate of infectious-related adverse events was similar between groups. In conclusion, anakinra improved overall survival and invasive ventilation-free survival and was well tolerated in patients with ARDS associated with COVID-19.
Copyright ? 2021 by The American Association of Immunologists, Inc.
. 2021 Feb 5;ji2001126.
doi: 10.4049/jimmunol.2001126. Online ahead of print.
IL-1 Receptor Antagonist Anakinra in the Treatment of COVID-19 Acute Respiratory Distress Syndrome: A Retrospective, Observational Study
Marco Franzetti[SUP] 1 [/SUP], Andrea Forastieri[SUP] 2 [/SUP], Noemi Borsa[SUP] 3 [/SUP], Alessandro Pandolfo[SUP] 4 [/SUP], Chiara Molteni[SUP] 4 [/SUP], Luca Borghesi[SUP] 4 [/SUP], Silvia Pontiggia[SUP] 4 [/SUP], Giulia Evasi[SUP] 2 [/SUP], Lorenzo Guiotto[SUP] 2 [/SUP], Mattia Erba[SUP] 2 [/SUP], Ugo Pozzetti[SUP] 5 [/SUP], Anna Ronchetti[SUP] 5 [/SUP], Letizia Valsecchi[SUP] 4 [/SUP], Gioacchino Castaldo[SUP] 4 [/SUP], Ernesto Longoni[SUP] 4 [/SUP], Daniele Colombo[SUP] 3 [/SUP], Marco Soncini[SUP] 5 [/SUP], Stefano Crespi[SUP] 6 [/SUP], Stefano Maggiolini[SUP] 7 [/SUP], Davide Guzzon[SUP] 8 [/SUP], Stefania Piconi[SUP] 4 [/SUP]
Affiliations
- PMID: 33547169
- DOI: 10.4049/jimmunol.2001126
Abstract
The IL-1 receptor antagonist, anakinra, may represent a therapeutic option for acute respiratory distress syndrome (ARDS) associated with coronavirus disease 2019 (COVID-19). In this study, COVID-19 ARDS patients admitted to the Azienda Socio Sanitaria Territoriale of Lecco, Italy, between March 5th to April 15th, 2020, and who had received anakinra off-label were retrospectively evaluated and compared with a cohort of matched controls who did not receive immunomodulatory treatment. The primary end point was survival at day 28. The population consisted of 112 patients (56 treated with anakinra and 56 controls). Survival at day 28 was obtained in 69 patients (61.6%) and was significantly higher in anakinra-treated patients than in the controls (75.0 versus 48.2%, p = 0.007). When stratified by continuous positive airway pressure support at baseline, anakinra-treated patients' survival was also significant compared with the controls (p = 0.008). Univariate analysis identified anakinra usage (odds ratio, 3.2; 95% confidence interval, 1.47-7.17) as a significant survival predictor. This was not supported by multivariate modeling. The rate of infectious-related adverse events was similar between groups. In conclusion, anakinra improved overall survival and invasive ventilation-free survival and was well tolerated in patients with ARDS associated with COVID-19.
Copyright ? 2021 by The American Association of Immunologists, Inc.