Canakinumab as treatment for COVID-19-related pneumonia: A prospective case-control study.

Autor: Generali D; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy; Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy. Electronic address: dgenerali@units.it., Bosio G; Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Malberti F; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Cuzzoli A; Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Testa S; Haemostasis and Thrombosis Center, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Romanini L; Radiology Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Fioravanti A; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Morandini A; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Pianta L; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Giannotti G; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Viola EM; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Giorgi-Pierfranceschi M; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Foramitti M; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Tira RA; Radiology Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Zangrandi I; Radiology Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Chiodelli G; Pharmacy Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Machiavelli A; Pharmacy Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Cappelletti MR; Haemostasis and Thrombosis Center, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Giossi A; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., De Giuli V; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Costanzi C; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Campana C; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Bernocchi O; Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Sirico M; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Zoncada A; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Molteni A; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy., Venturini S; Department of Management, University of Turin, Turin, Italy; Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy., Giudici F; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Scaltriti M; Department of Pathology and Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Pan A; COVID Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy.
Jazyk: angličtina
Zdroj: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2021 Mar; Vol. 104, pp. 433-440. Date of Electronic Publication: 2020 Dec 29.
DOI: 10.1016/j.ijid.2020.12.073
Abstrakt: Objectives: Canakinumab is an IL-1β antibody that neutralises the activity of IL-1β. This study examined the efficacy and safety of canakinumab in patients with moderate COVID-19-related pneumonia.
Design: This study aimed to evaluate the reduction in duration of hospitalisation with adequate oxygen status. Forty-eight patients with moderate COVID-19-related pneumonia were asked to participate in the prospective case-control study: 33 patients (cases) signed informed consent and received canakinumab (Cohort 1) and 15 patients (Controls) refused to receive the experimental drug and received institutional standard of care (Cohort 2).
Results: Hospital discharge within 21 days was seen in 63% of patients in Cohort 1 vs. 0% in Cohort 2 (median 14 vs. 26 days, respectively; p < 0.001). There was significant clinical improvement in ventilation regimes following administration of canakinumab compared with Cohort 2 (Stuart-Maxwell test for paired data, p < 0.001). Patients treated with canakinumab experienced a significant increase in PaO 2 :FiO 2 (p < 0.001) and reduction in lung damage by CT (p = 0.01), along with significant decreases in immune/inflammation markers that were not observed in Cohort 2. Only mild side-effects were seen in patients treated with canakinumab; survival at 60 days was 90.0% (95% CI 71.9-96.7) in patients treated with canakinumab and 73.3% (95% CI 43.6-89.1) for Cohort 2.
Conclusions: Treatment with canakinumab in patients with COVID-19-related pneumonia rapidly restored normal oxygen status, decreased the need for invasive mechanical ventilation, and was associated with earlier hospital discharge and favourable prognosis versus standard of care.
(Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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