Effectiveness of anakinra for tocilizumab-refractory severe COVID-19 : A single-centre retrospective comparative study
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: A subgroup of patients with SARS-CoV-2 infection was thought to have developed cytokine release syndrome and were treated with tocilizumab; however, a significant percentage of patients evolved. This study aimed to determine the usefulness of anakinra as a rescue treatment for patients with tocilizumab-refractory COVID-19 disease.
METHODS: A prospective cohort of patients with COVID-19 pneumonia who received anakinra as salvage therapy after failure of tocilizumab were compared (1:1) with selected controls in a historical cohort of patients treated with tocilizumab. Cases and controls were matched by age, comorbidities, pulse oximetry oxygen saturation to fraction of inspired oxygen (SpO2/FiO2) ratio at baseline, and time elapsed since the initiation of treatment with tocilizumab. The primary outcome was the improvement in clinical status measured by a 6-point ordinal scale, from baseline to day 21.
RESULTS: The study included 20 cases and 20 controls (mean age 65.3 ± 12.8 years, 65% males). No differences were found in the clinical improvement rates at 7, 14 and 21 days of follow-up. The in-hospital mortality rate for patients receiving anakinra was 55% vs. 45% in the control group (P = 0.527).
CONCLUSIONS: Treatment with anakinra was not useful in improving the prognosis of patients with tocilizumab-refractory severe COVID-19.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:105 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 105(2021) vom: 01. Apr., Seite 319-325 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de la Calle, Cristina [VerfasserIn] |
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| Links: |
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| Themen: |
Anakinra |
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| Anmerkungen: |
Date Completed 21.05.2021 Date Revised 28.03.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijid.2021.02.041 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM32151355X |
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| 100 | 1 | |a de la Calle, Cristina |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effectiveness of anakinra for tocilizumab-refractory severe COVID-19 |b A single-centre retrospective comparative study |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 21.05.2021 | ||
| 500 | |a Date Revised 28.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: A subgroup of patients with SARS-CoV-2 infection was thought to have developed cytokine release syndrome and were treated with tocilizumab; however, a significant percentage of patients evolved. This study aimed to determine the usefulness of anakinra as a rescue treatment for patients with tocilizumab-refractory COVID-19 disease | ||
| 520 | |a METHODS: A prospective cohort of patients with COVID-19 pneumonia who received anakinra as salvage therapy after failure of tocilizumab were compared (1:1) with selected controls in a historical cohort of patients treated with tocilizumab. Cases and controls were matched by age, comorbidities, pulse oximetry oxygen saturation to fraction of inspired oxygen (SpO2/FiO2) ratio at baseline, and time elapsed since the initiation of treatment with tocilizumab. The primary outcome was the improvement in clinical status measured by a 6-point ordinal scale, from baseline to day 21 | ||
| 520 | |a RESULTS: The study included 20 cases and 20 controls (mean age 65.3 ± 12.8 years, 65% males). No differences were found in the clinical improvement rates at 7, 14 and 21 days of follow-up. The in-hospital mortality rate for patients receiving anakinra was 55% vs. 45% in the control group (P = 0.527) | ||
| 520 | |a CONCLUSIONS: Treatment with anakinra was not useful in improving the prognosis of patients with tocilizumab-refractory severe COVID-19 | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Anakinra | |
| 650 | 4 | |a COVID-19 | |
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| 650 | 7 | |a tocilizumab |2 NLM | |
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| 700 | 1 | |a Aguado, José María |e verfasserin |4 aut | |
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