Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: results of a prospective, open-label, interventional study

https://doi.org/10.1016/j.ijid.2020.11.149

A prospective, open-label, interventional study (ISRCTN74727214) in adults hospitalized with severe COVID-19 pneumonia was conducted. Patients in the interventional arm received subcutaneous anakinra (100 mg twice daily for 3 days, followed by 100 mg daily for 7 days) in addition to standard treatment. Main outcomes were need for mechanical ventilation and in-hospital death.  A total of 69 patients were included; 45 anakinra-treated and 24 historical controls. Need for mechanical ventilation occurred in 14 (31%) in the anakinra-treated group and 18 (75%) in the historical cohort (p < 0.001). In-hospital death occurred in 13 (29%) in the anakinra-treated group and 11 (46%) in the historical cohort (p = 0.082). Successful weaning from supplemental oxygen to ambient air was attained in 25 (63%) in the anakinra-treated compared with 6 (27%) in the historical cohort (p = 0.008). Patients who received anakinra showed significant reduction in inflammatory biomarkers. In patients with severe COVID-19 pneumonia and high oxygen requirement, anakinra could represent an effective treatment option and may confer clinical benefit. 

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