Anakinra reduces Invasive Ventilation need in Non-Intubated COVID-19 Patients: Study

Acute respiratory distress syndrome and cytokine release syndrome are the major complications of coronavirus disease 2019 (COVID-19) associated with increased mortality risk.

Researchers have found in a new Systematic Review and Meta Analysis that anakinra reduces need for Invasive mechanical ventilation & mortality Risk amongst hospitalized non-Intubated COVID-19 patients.

Anakinra is a drug which is used to treat auto-inflammatory disorders.

The new study has been published in Rheumatology.

Two of the major complications associated with increased mortality risk in COVID-19 patients are Acute Respiratory Distress Syndrome and Cytokine Storm Syndrome. In severe cases, this results in organ failure and death. Researchers from the Faculty of Medicine at the School of Health Sciences, University of Ioannina, Greece, performed a meta-analysis to assess the efficacy and safety of Anakinra in adult hospitalized non-intubated patients with COVID-19.

Relevant trials were identified by searching literature until 24 April 2021 using the following keywords: 'Anakinra, Interleukin 1, Coronavirus, COVID-19, SARS-CoV-2'. According to the inclusion criteria, trials evaluating the effect of Anakinra on the need for invasive mechanical ventilation and mortality in hospitalized non-intubated patients with COVID-19 were reviewed. Nine studies, which included 1,119 patients, were eligible for inclusion in the meta-analysis.

The bias risk of the study was high. However, the following results were revealed –

i) In pooled analyses, anakinra reduced the need for invasive mechanical ventilation (odds ratio, OR: 0·38, 95% confidence interval, CI: 0·17-0·85, p= 0.02, I2=67%; 6 studies, n = 587).

ii) In pooled analyses, anakinra reduced the mortality risk (OR: 0·32, 95% CI: 0·23-0·45, p< 0·00001, I2=0%; 9 studies, n = 1,119) compared with standard of care therapy.

iii) There were no differences regarding the risk of adverse events, including liver dysfunction (OR: 0·75, 95% CI: 0·48-1·16, p> 0·05, I2=28%; 5 studies, n = 591) and bacteremia (OR: 1·07, 95% CI: 0·42-2·73, p> 0·05, I2=71%; 6 studies, n = 727).

"Available evidence shows that treatment with Anakinra reduces both the need for invasive mechanical ventilation and mortality risk of hospitalized non-intubated patients with COVID-19 without increasing the risk of adverse events. Confirmation of efficacy and safety requires randomized placebo-controlled trials," the research team concluded.

Reference:

Study titled, "Anakinra in hospitalized non-intubated patients with coronavirus disease 2019: a systematic review and meta-analysis," published in Rheumatology.

DOI: 10.1093/rheumatology/keab447