Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study.
Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study.
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DOI：
10.1016/j.ijid.2020.11.149
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Balkhair O
中科院分区：
文献类型：
--
作者：
Balkhair A;Al-Zakwani I;Al Busaidi M;Al-Khirbash A;Al Mubaihsi S;BaTaher H;Al Aghbari J;Al Busaidi I;Al Kindi M;Baawain S;Al Alawi A;Al Lawati A;Al Rawahi B;Al-Baimani K;Al Zidi K;Elfatih N;Dawud B;John B;Rehman F;Yousif F;Al Khadouri G;Saber I;Lal J;Gargouri M;Al-Ward M;AbuDraz N;Al Ruqeishi S;Kumar S;Abdelmottaleb W;Al-Naamani Z;Bin Nazar Z;Balkhair O
本研究的目的是评估阿那白那在因COVID-19重症肺炎住院需要吸氧治疗的患者中的疗效。对住院的成人COVID-19重症肺炎患者进行了一项前瞻性、开放标签、介入性研究。介入组患者在标准治疗的基础上皮下注射阿那白拉（100mg，每日两次，连续3天，随后100mg，连续7天）。主要结局为需要机械通气和院内死亡。次要结果包括成功脱离补充氧和炎症生物标志物的变化。结果与接受标准治疗和支持性护理的历史对照组进行比较。共纳入69例患者：45例接受阿那白治疗，24例历史对照组。阿那金组有14人（31%）需要机械通气，历史队列中有18人（75%）需要机械通气（p < 0.001）。阿那金组住院死亡13例（29%），历史队列住院死亡11例（46%）（p = 0.082）。anakinra治疗组中25例（63%）成功断奶，而历史队列中6例（27%）成功断奶（p = 0.008）。接受阿那白的患者炎症生物标志物显著降低。对于重症COVID-19肺炎和高需氧量患者，阿那白可能是一种有效的治疗选择，并可能带来临床益处。ISRCTN74727214。
The aim of this study was to evaluate the efficacy of anakinra in patients who were admitted to hospital for severe COVID-19 pneumonia requiring oxygen therapy. A prospective, open-label, interventional study in adults hospitalized with severe COVID-19 pneumonia was conducted. Patients in the interventional arm received subcutaneous anakinra (100 mg twice daily for 3 days, followed by 100 mg daily for 7 days) in addition to standard treatment. Main outcomes were the need for mechanical ventilation and in-hospital death. Secondary outcomes included successful weaning from supplemental oxygen and change in inflammatory biomarkers. Outcomes were compared with those of historical controls who had received standard treatment and supportive care. A total of 69 patients were included: 45 treated with anakinra and 24 historical controls. A need for mechanical ventilation occurred in 14 (31%) of the anakinra-treated group and 18 (75%) of the historical cohort (p < 0.001). In-hospital death occurred in 13 (29%) of the anakinra-treated group and 11 (46%) of the historical cohort (p = 0.082). Successful weaning from supplemental oxygen to ambient air was attained in 25 (63%) of the anakinra-treated group compared with 6 (27%) of the historical cohort (p = 0.008). Patients who received anakinra showed a significant reduction in inflammatory biomarkers. In patients with severe COVID-19 pneumonia and high oxygen requirement, anakinra could represent an effective treatment option and may confer clinical benefit. ISRCTN74727214.
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