Study Investigates Anakinra’s Effectiveness for COVID-19 Treatment

Background on COVID-19 Severity

A recent study published in The Lancet Rheumatology explores the potential of the immunotherapy drug anakinra in treating COVID-19. As COVID-19 cases continue to rise globally, the majority of infections remain mild. However, some individuals experience severe symptoms that necessitate hospitalization. Finding effective treatments for critical cases is crucial, particularly for patients who struggle to overcome the virus. Improved treatment options can enhance patient outcomes and alleviate pressure on overwhelmed healthcare facilities until a vaccine becomes available.

The Role of Cytokines in COVID-19

Cytokines are vital components of the immune system, essential for eradicating infections. In severe COVID-19 cases, a heightened inflammatory response leads to an excessive production of cytokines, potentially resulting in acute respiratory distress syndrome (ARDS). Given that ARDS is a leading cause of mortality in COVID-19 patients, reducing this risk is imperative.

Potential of Anakinra in ARDS Prevention

Researchers speculate that certain immunotherapy drugs may mitigate ARDS, given the immune system’s significant role in its development. Anakinra, primarily used for treating rheumatoid arthritis, blocks the pro-inflammatory cytokine IL-1 and is thought to diminish the intensity of inflammatory responses. To evaluate anakinra’s effectiveness for COVID-19, a study was conducted in Italy and published in The Lancet Rheumatology.

Study Design and Results

The study included 45 hospitalized COVID-19 patients aged 18 and older who were experiencing moderate to severe ARDS. The treatment group comprised 29 patients who received intravenous anakinra at a dosage of 5mg/kg body weight twice daily, alongside standard care and non-invasive ventilation. In contrast, the control group consisted of 16 patients who received only standard care and non-invasive ventilation, with standard treatment involving two daily oral doses of 400mg lopinavir, 100mg ritonavir, and 200mg hydroxychloroquine.

After 21 days, 72% of the treatment group showed improvement in respiratory function, compared to 50% in the control group. Additionally, 17% of the treatment group required mechanical ventilation, versus 6% in the control group. Mortality rates were also significantly different, with 10% of the treatment group dying compared to 44% of the control group. Bacteraemia, defined as the presence of bacteria in typically sterile blood, occurred in 14% of the treatment group and 13% of the control group.

Conclusion and Future Research Directions

The findings of this study suggest that anakinra may be beneficial in aiding recovery for COVID-19 patients. However, further research is necessary to validate these results due to the limited sample size. Additionally, more studies are needed to explore strategies for preventing bacteraemia during COVID-19 treatment to enhance patient outcomes.

References

Cavalli, G., De Luca, G., & Campochiaro, C., et al. (2020). Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyper inflammation: a retrospective cohort study. The Lancet Rheumatology, 1–7. doi: 10.1016/S2665-9913(20)30127

The Lancet Rheumatology: Small observational study of patients with severe COVID-19 treated with the arthritis drug anakinra finds clinical improvements. (2020, May 7). Retrieved May 13, 2020, from https://www.eurekalert.org/pub_releases/2020-05/tl-pss050720.php

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