The Safety and Efficacy of the Interleukin-1 Antagonist Anakinra in Severe Cases of COVID-19- A Systematic Review and Meta-analysis

Autor: Zeryab Ghous Dogar, Pousette Hamid, Sarabjot Singh Makkar, Alaa Hamdan, Marcos A. Sanchez-Gonzalez, Rishan Jeyakumar, Enkhmaa Luvsannyam, Trissa Paul, Saloni Shirke, Chala Riddick, Rockeven Desir, Rupalakshmi Vijayan, Manoj R Somagutta, Prathima Guntipalli, Manasa Sindhura Nagineni, Muhammad Adnan Khan, Neguemadji Ngardig Ngaba, Maria Kezia Lourdes Pormento, Sukrut Pagad
Rok vydání: 2020
Předmět:
DOI: 10.21203/rs.3.rs-111495/v2
Popis: This study aims to assess anakinra's safety and efficacy for treating severe coronavirus disease in 2019 (COVID-19). PubMed, Google Scholar, Cochrane Library, Embase, Scopus, medRxiv, and bioRxiv were searched. Three retrospective studies and five case series involving 3,274 adult patients with severe COVID-19 were included, 621 treated with anakinra (whether administered alone or in combination with other drugs) and 1,565 in the control group arm. All-cause mortality of severe COVID-19 patients among the anakinra group was 20% (16/81), which was lower than that in the control group (65%; 39/60). The difference was statistically significant [hazard ratio (HR) = 0.13, 95% confidence interval (CI) 0.06–0.29, I2= 0%]. The mechanical ventilation requirement with OR 0.57 (0.11-2.84, I2=87%) was not significantly better compared to the control group. For the safety of anakinra, we evaluated thromboembolism risk and liver enzyme elevation. Thromboembolism risk with OR: 1.48 (0.55- 3.99, I2=0%) and elevation in liver transaminases with OR 0.67 (0.11-3.93, I2=66%) were not statistically significant over the control group. However, these non-significant differences 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.
Databáze: OpenAIRE