Your browser doesn't support javascript.
Interleukin-6 blockade with sarilumab in severe COVID-19 pneumonia with systemic hyperinflammation: an open-label cohort study.
Della-Torre, Emanuel; Campochiaro, Corrado; Cavalli, Giulio; De Luca, Giacomo; Napolitano, Angela; La Marca, Salvatore; Boffini, Nicola; Da Prat, Valentina; Di Terlizzi, Gaetano; Lanzillotta, Marco; Rovere Querini, Patrizia; Ruggeri, Annalisa; Landoni, Giovanni; Tresoldi, Moreno; Ciceri, Fabio; Zangrillo, ALberto; De Cobelli, Francesco; Dagna, Lorenzo.
  • Della-Torre E; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, San Raffaele Hospital, Milano, Lombardia, Italy dellatorre.emanuel@hsr.it dagna.lorenzo@unisr.it.
  • Campochiaro C; Università Vita-Salute San Raffaele, Milan, Italy.
  • Cavalli G; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, San Raffaele Hospital, Milano, Lombardia, Italy.
  • De Luca G; Università Vita-Salute San Raffaele, Milan, Italy.
  • Napolitano A; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, San Raffaele Hospital, Milano, Lombardia, Italy.
  • La Marca S; Università Vita-Salute San Raffaele, Milan, Italy.
  • Boffini N; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, San Raffaele Hospital, Milano, Lombardia, Italy.
  • Da Prat V; Università Vita-Salute San Raffaele, Milan, Italy.
  • Di Terlizzi G; Università Vita-Salute San Raffaele, Milan, Italy.
  • Lanzillotta M; Clinical and Experimental Radiology Unit, Experimental Imaging Center, San Raffaele Hospital, Milan, Italy.
  • Rovere Querini P; Università Vita-Salute San Raffaele, Milan, Italy.
  • Ruggeri A; Clinical and Experimental Radiology Unit, Experimental Imaging Center, San Raffaele Hospital, Milan, Italy.
  • Landoni G; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, San Raffaele Hospital, Milano, Lombardia, Italy.
  • Tresoldi M; General Medicine and Advanced Care Unit, San Raffaele Hospital, Milan, Italy.
  • Ciceri F; General Medicine and Advanced Care Unit, San Raffaele Hospital, Milan, Italy.
  • Zangrillo A; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, San Raffaele Hospital, Milano, Lombardia, Italy.
  • De Cobelli F; Università Vita-Salute San Raffaele, Milan, Italy.
  • Dagna L; Università Vita-Salute San Raffaele, Milan, Italy.
Ann Rheum Dis ; 79(10): 1277-1285, 2020 10.
Article in English | MEDLINE | ID: covidwho-634384
Semantic information from SemMedBD (by NLM)
1. sarilumab ASSOCIATED_WITH Pneumonia
Subject
sarilumab
Predicate
ASSOCIATED_WITH
Object
Pneumonia
2. sarilumab INHIBITS interleukin-6
Subject
sarilumab
Predicate
INHIBITS
Object
interleukin-6
3. sarilumab TREATS Pneumonia
Subject
sarilumab
Predicate
TREATS
Object
Pneumonia
4. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
5. sarilumab TREATS Patients
Subject
sarilumab
Predicate
TREATS
Object
Patients
6. sarilumab TREATS Lung consolidation
Subject
sarilumab
Predicate
TREATS
Object
Lung consolidation
7. Lung consolidation PROCESS_OF Patients
Subject
Lung consolidation
Predicate
PROCESS_OF
Object
Patients
8. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
9. sarilumab ASSOCIATED_WITH Pneumonia
Subject
sarilumab
Predicate
ASSOCIATED_WITH
Object
Pneumonia
10. sarilumab INHIBITS interleukin-6
Subject
sarilumab
Predicate
INHIBITS
Object
interleukin-6
11. sarilumab TREATS Pneumonia
Subject
sarilumab
Predicate
TREATS
Object
Pneumonia
12. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
13. sarilumab TREATS Patients
Subject
sarilumab
Predicate
TREATS
Object
Patients
14. sarilumab TREATS Lung consolidation
Subject
sarilumab
Predicate
TREATS
Object
Lung consolidation
15. Lung consolidation PROCESS_OF Patients
Subject
Lung consolidation
Predicate
PROCESS_OF
Object
Patients
16. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

OBJECTIVES:

To assess the safety and efficacy of interleukin (IL)-6 blockade with sarilumab in patients with severe COVID-19 pneumonia and systemic hyperinflammation.

METHODS:

We conducted an open-label study of sarilumab in severe COVID-19 pneumonia (PaO2/FiO2 <300 mm Hg) with hyperinflammation (elevated inflammatory markers and serum IL-6 levels). Sarilumab 400 mg was administered intravenously in addition to standard of care and results were compared with contemporary matched patients treated with standard of care alone. Clinical improvement, mortality, safety and predictors of response were assessed at 28 days.

RESULTS:

Twenty-eight patients were treated with sarilumab and 28 contemporary patients receiving standard of care alone were used as controls. At day 28 of follow-up, 61% of patients treated with sarilumab experienced clinical improvement and 7% died. These findings were not significantly different from the comparison group (clinical improvement 64%, mortality 18%; p=NS). Baseline PaO2/FiO2 ratio >100 mm Hg and lung consolidation <17% at CT scan predicted clinical improvement in patients treated with sarilumab. Median time to clinical improvement in patients with lung consolidation <17% was shorter after sarilumab (10 days) than after standard treatment (24 days; p=0.01). The rate of infection and pulmonary thrombosis was similar between the two groups.

CONCLUSIONS:

At day 28, overall clinical improvement and mortality in patients with severe COVID-19 were not significantly different between sarilumab and standard of care. Sarilumab was associated with faster recovery in a subset of patients showing minor lung consolidation at baseline.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / C-Reactive Protein / Interleukin-6 / Coronavirus Infections / Antibodies, Monoclonal, Humanized / Inflammation Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Country/Region as subject: Europa Language: English Journal: Ann Rheum Dis Year: 2020 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / C-Reactive Protein / Interleukin-6 / Coronavirus Infections / Antibodies, Monoclonal, Humanized / Inflammation Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Country/Region as subject: Europa Language: English Journal: Ann Rheum Dis Year: 2020 Document Type: Article