Anakinra in hospitalized non-intubated patients with coronavirus disease 2019: a Systematic review and meta-analysis.
Rheumatology (Oxford)
; 60(12): 5527-5537, 2021 12 01.
Article
in English
| MEDLINE | ID: covidwho-1231045
ABSTRACT
OBJECTIVES:
Acute respiratory distress syndrome and cytokine release syndrome are the major complications of coronavirus disease 2019 (COVID-19) associated with increased mortality risk. We performed a meta-analysis to assess the efficacy and safety of anakinra in adult hospitalized non-intubated patients with COVID-19.METHODS:
Relevant trials were identified by searching literature until 24 April 2021 using the following terms anakinra, IL-1, coronavirus, COVID-19, SARS-CoV-2. Trials evaluating the effect of anakinra on the need for invasive mechanical ventilation and mortality in hospitalized non-intubated patients with COVID-19 were included.RESULTS:
Nine studies (n = 1119) were eligible for inclusion in the present meta-analysis. Their bias risk with reference to the assessed parameters was high. In pooled analyses, anakinra reduced the need for invasive mechanical ventilation (odds ratio (OR) 0.38, 95% CI 0.17-0.85, P = 0.02, I2 = 67%; six studies, n = 587) and mortality risk (OR 0.32, 95% CI 0.23-0.45, P < 0.00001, I2 = 0%; nine studies, n = 1119) compared with standard of care therapy. There were no differences regarding the risk of adverse events, including liver dysfunction (OR 0.75, 95% CI 0.48-1.16, P > 0.05, I2 = 28%; five studies, n = 591) and bacteraemia (OR 1.07, 95% CI 0.42-2.73, P > 0.05, I2 = 71%; six studies, n = 727).CONCLUSIONS:
Available evidence shows that treatment with anakinra reduces both the need for invasive mechanical ventilation and mortality risk of hospitalized non-intubated patients with COVID-19 without increasing the risk of adverse events. Confirmation of efficacy and safety requires randomized placebo-controlled trials.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Receptors, Interleukin-1
/
Interleukin 1 Receptor Antagonist Protein
/
COVID-19 Drug Treatment
Type of study:
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
Language:
English
Journal:
Rheumatology (Oxford)
Journal subject:
Rheumatology
Year:
2021
Document Type:
Article
Affiliation country:
Rheumatology
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