Anakinra or tocilizumab for prevention of COVID-19 death? A big dilemma

Patoulias, Dimitrios; Dimosiari, Athina; Michailidis, Theodoros

doi:10.1016/j.ejim.2021.05.039

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Anakinra treatment seems to be safer with respect to 30 days mortality and secondary infection-related events, which were more frequent in patients receiving tocilizumab without a statistically significant difference between the groups as reported from other authors [10] . This may be possibly related to the different half-life of tocilizumab and anakinra treatments.…”

supporting

confidence: 62%

Statistical models to predict clinical outcomes with anakinra vs. tocilizumab treatments for severe pneumonia in COVID19 patients

Piconi

Pontiggia

Franzetti

et al. 2023

European Journal of Internal Medicine

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supporting

confidence: 62%

Statistical models to predict clinical outcomes with anakinra vs. tocilizumab treatments for severe pneumonia in COVID19 patients

Piconi

Pontiggia

Franzetti

et al. 2023

European Journal of Internal Medicine

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“…However, to date, there is no evidence showing which anti-IL drug is the most effective. Scarce data have compared the efficacy of tocilizumab versus anakinra in dexamethasone-refractory COVID-19 patients (14,15). We aimed to retrospectively compare the outcomes of dexamethasone-refractory COVID-19 patients treated with tocilizumab or anakinra using propensity score matching.…”

Section: Introductionmentioning

confidence: 99%

Tocilizumab versus anakinra in COVID-19: results from propensity score matching

Arcani,

Correard,

Suchon

et al. 2023

Front. Immunol.

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BackgroundTocilizumab and anakinra are anti-interleukin drugs to treat severe coronavirus disease 2019 (COVID-19) refractory to corticosteroids. However, no studies compared the efficacy of tocilizumab versus anakinra to guide the choice of the therapy in clinical practice. We aimed to compare the outcomes of COVID-19 patients treated with tocilizumab or anakinra.MethodsOur retrospective study was conducted in three French university hospitals between February 2021 and February 2022 and included all the consecutive hospitalized patients with a laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection assessed by RT-PCR who were treated with tocilizumab or anakinra. A propensity score matching was performed to minimize confounding effects due to the non-random allocation.ResultsAmong 235 patients (mean age, 72 years; 60.9% of male patients), the 28-day mortality (29.4% vs. 31.2%, p = 0.76), the in-hospital mortality (31.7% vs. 33.0%, p = 0.83), the high-flow oxygen requirement (17.5% vs. 18.3%, p = 0.86), the intensive care unit admission rate (30.8% vs. 22.2%, p = 0.30), and the mechanical ventilation rate (15.4% vs. 11.1%, p = 0.50) were similar in patients receiving tocilizumab and those receiving anakinra. After propensity score matching, the 28-day mortality (29.1% vs. 30.4%, p = 1) and the rate of high-flow oxygen requirement (10.1% vs. 21.5%, p = 0.081) did not differ between patients receiving tocilizumab or anakinra. Secondary infection rates were similar between the tocilizumab and anakinra groups (6.3% vs. 9.2%, p = 0.44).ConclusionOur study showed comparable efficacy and safety profiles of tocilizumab and anakinra to treat severe COVID-19.

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