• eLife · Mar 2021

    Clinical Trial

    An open label trial of anakinra to prevent respiratory failure in COVID-19.

    • Evdoxia Kyriazopoulou, Periklis Panagopoulos, Symeon Metallidis, George N Dalekos, Garyphallia Poulakou, Nikolaos Gatselis, Eleni Karakike, Maria Saridaki, Georgia Loli, Aggelos Stefos, Danai Prasianaki, Sarah Georgiadou, Olga Tsachouridou, Vasileios Petrakis, Konstantinos Tsiakos, Maria Kosmidou, Vassiliki Lygoura, Maria Dareioti, Haralampos Milionis, Ilias C Papanikolaou, Karolina Akinosoglou, Dimitra-Melia Myrodia, Areti Gravvani, Aliki Stamou, Theologia Gkavogianni, Konstantina Katrini, Theodoros Marantos, Ioannis P Trontzas, Konstantinos Syrigos, Loukas Chatzis, Stamatios Chatzis, Nikolaos Vechlidis, Christina Avgoustou, Stamatios Chalvatzis, Miltiades Kyprianou, Jos Wm van der Meer, Jesper Eugen-Olsen, Mihai G Netea, and Evangelos J Giamarellos-Bourboulis.
    • 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.
    • Elife. 2021 Mar 8; 10.

    BackgroundIt was studied if early suPAR-guided anakinra treatment can prevent severe respiratory failure (SRF) of COVID-19.MethodsA total of 130 patients with suPAR ≥6 ng/ml were assigned to subcutaneous anakinra 100 mg once daily for 10 days. Primary outcome was SRF incidence by day 14 defined as any respiratory ratio below 150 mmHg necessitating mechanical or non-invasive ventilation. Main secondary outcomes were 30-day mortality and inflammatory mediators; 28-day WHO-CPS was explored. Propensity-matched standard-of care comparators were studied.Results22.3% with anakinra treatment and 59.2% comparators (hazard ratio, 0.30; 95% CI, 0.20-0.46) progressed into SRF; 30-day mortality was 11.5% and 22.3% respectively (hazard ratio 0.49; 95% CI 0.25-0.97). Anakinra was associated with decrease in circulating interleukin (IL)-6, sCD163 and sIL2-R; IL-10/IL-6 ratio on day 7 was inversely associated with SOFA score; patients were allocated to less severe WHO-CPS strata.ConclusionsEarly suPAR-guided anakinra decreased SRF and restored the pro-/anti-inflammatory balance.FundingThis study was funded by the Hellenic Institute for the Study of Sepsis, Technomar Shipping Inc, Swedish Orphan Biovitrum, and the Horizon 2020 Framework Programme.Clinical Trial NumberNCT04357366.© 2021, Kyriazopoulou et al.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…