IL-1 Receptor Antagonist Anakinra in the Treatment of COVID-19 Acute Respiratory Distress Syndrome: A Retrospective, Observational Study
| Autor: | Chiara Molteni, Letizia Valsecchi, Gioacchino Castaldo, Daniele Colombo, Mattia Erba, Stefania Piconi, Alessandro Pandolfo, Andrea Forastieri, Davide Guzzon, Stefano Maggiolini, Ernesto Longoni, Ugo Pozzetti, Silvia Pontiggia, Marco Soncini, Lorenzo Guiotto, Luca Borghesi, Anna Ronchetti, Marco Franzetti, Giulia Evasi, Noemi Borsa, Stefano Crespi |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty ARDS Infectious Disease and Host Response medicine.medical_treatment Immunology Population Severe Acute Respiratory Syndrome Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Immunology and Allergy Humans Continuous positive airway pressure education Survival rate Aged Retrospective Studies Univariate analysis Anakinra education.field_of_study business.industry SARS-CoV-2 COVID-19 Retrospective cohort study Odds ratio Middle Aged medicine.disease Respiration Artificial Survival Rate Interleukin 1 Receptor Antagonist Protein Female business 030215 immunology medicine.drug |
| Zdroj: | J Immunol |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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