{"id":37863,"date":"2020-05-14T08:34:54","date_gmt":"2020-05-14T08:34:54","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=37863"},"modified":"2020-09-11T11:08:15","modified_gmt":"2020-09-11T11:08:15","slug":"rheumatoid-arthritis-drug-anakinra-in-small-study-to-treat-covid-19","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/37863","title":{"rendered":"Rheumatoid arthritis drug anakinra in small study to treat COVID-19"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/span><\/strong><\/p>\n

A small observational study reported in Lancet Rheumatology used the rheumatoid arthritis drug anakinra, a recombinant interleukin-1 receptor antagonist, for the treatment of COVID-19. [1]<\/span><\/strong><\/p>\n

The study was conducted in Milan in 29 patients hospitalised with COVID-19 (median age 62, many with comorbidities) who received daily high-dose intravenous infusions of anakinra at 10 mg\/kg bodyweight for 21 days in addition to standard of care standard care (non-invasive ventilation (CPAP), hydroxychloroquine, and lopinavir\/r). Results were compared to a non-randomised control group of 16 people who only received standard of care.<\/span><\/p>\n

Respiratory improvements and reduced signs of cytokine activity including reduced C-reactive protein was reported in 72% (21\/29) of patients. Survival was 90% (26 out of 29). Five of 29 patients (17%) needed mechanical ventilation. <\/span><\/p>\n

This compared to persistent or recurrent increases in C-reactive protein in most of the control group. Respiratory function improved for half of the patients (8 patients, 50%), and 56% (nine of 16) survived. One patient received mechanical ventilation (6%).<\/span><\/p>\n

The authors commented that anakinra has a stronger safety record compared with other cytokine-blocking agents and a shorter half-life, making it suitable for critically ill patients, but that their findings needed to be tested in larger randomised studies.<\/span><\/p>\n

The study is also part of the prospective 1000-person COVID-19 Biobank study looking for predictors of response and outcomes to COVID-19. [2]<\/span><\/p>\n

comment<\/h3>\n

A second study, reported in Lancet Rheumatology, included 52 adults hospitalised with COVID-19 from 26 March to 6 April 2020, who were treated with subcutaneous anakinra (100 mg twice a day for 72 h, then 100 mg daily for 7 days). Results were compared to 44 historical controls with similar baseline characteristics. [3]<\/strong><\/p>\n

The study reported\u00a0lower rates of ICU admission (for invasive mechanical ventilation) or death with anakinra: 13 (25%) vs 32 (73%); hazard ratio: 0.22 (95%CI 0.11 to 0.41), p<0\u00b70001. This remained significant in multivariate analysis; HR: 0.22 (95%CI: 0.10 to 0.49), p=0\u00b70002. Increases in liver aminotransferases were reported in seven (13%) vs four (9%) patients, respectively.<\/strong><\/p>\n

Reference<\/span><\/p>\n

    \n
  1. Cavalli G et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatology DOI: 10.1016\/S2665-9913(20)30127-2. (7 May 2020).
    \n<\/span>https:\/\/www.thelancet.com\/journals\/lanrhe\/article\/PIIS2665-9913(20)30127-2\/fulltext<\/span><\/a><\/li>\n
  2. clinicaltrials.gov. COVID-19 Patients characterization, biobank, treatment response and outcome predictor (COVID-BioB).
    \n<\/span>    https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04318366<\/span><\/a><\/li>\n
  3. Huet T et al. Anakinra for severe forms of COVID-19: a cohort study. Lancet Rheumatology. DOI: 10.1016\/S2665-9913(20)30164-8. (29 May 2020)
    \n    https:\/\/www.thelancet.com\/journals\/lanrhe\/article\/PIIS2665-9913(20)30164-8\/fulltext<\/a><\/li>\n<\/ol>\n

    This report was updated to included comments about the second study on 29 May 2020.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base A small observational study reported in Lancet Rheumatology used the rheumatoid arthritis drug anakinra, a recombinant interleukin-1 receptor antagonist, for the treatment of COVID-19. [1] The study was conducted in Milan in 29 patients hospitalised with …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[283,278],"tags":[],"class_list":["post-37863","post","type-post","status-publish","format-standard","hentry","category-covid-19-investigational-drugs","category-covid-19"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/37863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=37863"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/37863\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=37863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=37863"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=37863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}