IL-1 Receptor Antagonist Anakinra in the Treatment of COVID-19 Acute Respiratory Distress Syndrome: A Retrospective, Observational Study.
J Immunol
; 206(7): 1569-1575, 2021 04 01.
Artigo
em Inglês
| MEDLINE | ID: covidwho-1067833
ABSTRACT
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.
Texto completo:
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Coleções:
Bases de dados internacionais
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Síndrome Respiratória Aguda Grave
/
Proteína Antagonista do Receptor de Interleucina 1
/
SARS-CoV-2
/
COVID-19
Tipo de estudo:
Estudo de coorte
/
Estudo experimental
/
Estudo observacional
/
Estudo prognóstico
/
Ensaios controlados aleatorizados
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
/
Meia-Idade
Idioma:
Inglês
Revista:
J Immunol
Ano de publicação:
2021
Tipo de documento:
Artigo
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