Anakinra after treatment with corticosteroids alone or with tocilizumab in patients with severe COVID‑19 pneumonia and moderate hyperinflammation. A retrospective cohort study: reply

Millán, Ismael Francisco Aomar; Salvatierra, Juan; Hernández-Quero, José

doi:10.1007/s11739-021-02690-3

Cited by 15 publications

(1 citation statement)

References 5 publications

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“…Interleukin-1 and IL-6 are proinflammatory cytokines which have been demonstrated to be major contributors to development of hyperinflammatory response in COVID-19. Interleukin-1a is one of the initial cytokines released in COVID-19, inducing IL-6, TNF-α, granulocyte-macrophage colony stimulating factor (GM-CSF), and IL-17 expression after binding to its receptor [ 6 ]. Likewise, overproduction of IL-6 reported to drive the immune dysregulation in severe COVID-19 patients [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of anakinra and tocilizumab in management of severe COVID-19: a retrospective cohort study

Küçükşahin

Erden

Karakaş

et al. 2022

Turkish Journal of Medical Sciences

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Background/aim Studies regarding effectiveness of anakinra and tocilizumab treatments in coronavirus disease 2019 (COVID-19) have contradictory results. Furthermore, there is scarce comparative data regarding superiority of any agent. To further elucidate any superiority between these two agents, we retrospectively investigated and compared outcomes in hospitalized COVID-19 patients of our inpatient cohort who received anakinra or tocilizumab. Materials and methods This study was designed as a single-center, retrospective, cross-sectional cohort study. Hospitalized patients with confirmed diagnosis of COVID-19 who had Brescia-COVID respiratory severity scale score ≥3 and hyperinflammation (defined as elevation of C reactive protein ≥50 g/L or ferritin ≥700 ng/mL) and received anakinra or tocilizumab in addition to standard care were enrolled in the study. Length of hospital stay after initiation of antiinflammatory treatment, need for mechanical ventilation, need for intensive care unit admission, mortality were set as primary outcomes and compared between tocilizumab and anakinra recipients after propensity score matching. Results One hundred and six patients were placed in each group after propensity score matching. In the anakinra group, relative risk reduction for intensive care unit admission was 50% when compared to the tocilizumab group and the number needed to treat to avert an intensive care unit admission was 3 (95% CI, 2–5). In terms of mortality, a 52% relative risk reduction was observed with anakinra treatment and the number needed to treat to avert an intensive care unit admission was 8 (95% CI, 4–50). Significantly more patients were observed to receive glucocorticoids in the anakinra group. Conclusion Anakinra administration in severe COVID-19 patients was significantly associated with better survival and greater clinical improvement compared to the tocilizumab administration in our study. Increased rate of glucocorticoid use in the anakinra group might have contributed to better outcomes.

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Section: Introductionmentioning

confidence: 99%

Comparison of anakinra and tocilizumab in management of severe COVID-19: a retrospective cohort study

Küçükşahin

Erden

Karakaş

et al. 2022

Turkish Journal of Medical Sciences

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COVID‐19 Disease in Patients With Recurrent Pericarditis During Treatment With Anakinra: Comment on the Article by Navarro‐Millán et al

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Trotta

Pancrazi

et al. 2021

Arthritis & Rheumatology

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Anakinra treatment efficacy in reduction of inflammatory biomarkers in COVID‐19 patients: A meta‐analysis

Naveed

Sarwar

Ali

et al. 2022

Clinical Laboratory Analysis

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Introduction Anakinra is being empirically considered for the treatment of COVID‐19 patients. The aim is to assess the efficacy of anakinra treatment on inflammatory marker reduction, including c‐reactive protein (CRP) concentrations, serum ferritin, and serum d‐dimer levels. Methods Adhering to PRISMA 2020 statement guidelines, a systematic search was conducted across the following databases from December 2019 until January 10, 2022: PubMed/MEDLINE, Cochrane Central, Web of Science, Scopus, and EMBASE. The following keywords were employed: Anakinra, COVID*, SARS‐CoV‐2, inflammatory, CRP, D‐dimer, Ferritin, hematological, laboratory, clinical, trials. The findings were collated and presented in a tabulated manner, and statistically analyzed using Review Manger 5.4 (Cochrane). Results In total, 2032 patients were included (881 in the anakinra and 1151 in the control/standard care group); 69.1% of them were males. Overall, the mean difference from admission until last follow‐up in CRP values was −9.66, where notable reductions were seen in the anakinra group (SMD = −0.46, p < 0.00001, N = 655). Serum ferritin mean values were reduced by 1467.16 in the anakinra group (SMD = −0.31, p = 0.004, N = 537). D‐dimer mean values were largely reduced by 4.04 in the anakinra group (SMD = −0.38, p = 0.0004, N = 375). Conclusion This study finds that anakinra is potentially a strong candidate as an anti‐inflammatory agent to reduce mortality in COVID‐19 patients, specifically in patients with elevated inflammatory biomarkers.

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Anakinra after treatment with corticosteroids alone or with tocilizumab in patients with severe COVID‑19 pneumonia and moderate hyperinflammation. A retrospective cohort study: reply

Cited by 15 publications

References 5 publications

Comparison of anakinra and tocilizumab in management of severe COVID-19: a retrospective cohort study

Comparison of anakinra and tocilizumab in management of severe COVID-19: a retrospective cohort study

COVID‐19 Disease in Patients With Recurrent Pericarditis During Treatment With Anakinra: Comment on the Article by Navarro‐Millán et al

Anakinra treatment efficacy in reduction of inflammatory biomarkers in COVID‐19 patients: A meta‐analysis

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