A drug, anakinra, originally intended for rheumatic diseases, gives “encouraging” results for severe forms of Covid-19 disease by reducing the risk of death and the need to be put on a ventilator in intensive care, according to a French study that offers a glimmer of hope.
“The significant reduction in mortality associated with the use of anakinra for Covid-19 in this study is encouraging in these difficult times,” writes rheumatologist Randy Cron of the University of Alabama (Birmingham, United States) in the specialist journal The Lancet Rheumatology, where the study appears. He underlines the “favorable safety profile” of this drug well known to rheumatologists.
The goal is to counter the “cytokine storm”, an uncontrolled inflammatory reaction implicated in severe forms of Covid-19 pneumonia, leading to acute respiratory distress syndrome (ARDS). A situation where the lungs do not provide enough oxygen to the vital organs, which requires the assistance of artificial ventilation with the use of a respirator.
More specifically, anakinra targets, to block, one of the cytokines involved in this “inflammatory storm”, interleukin-1 (IL-1). According to the medical team, Thomas Huet and his colleagues, from the Paris Saint-Joseph Hospital Group (GHPSJ), administration by subcutaneous injection for 10 days of anakinra (trade name: Kineret), to 52 patients with ‘a severe form of COVID-19 has resulted in a “statistically significant reduction in the risk of death and transition to intensive care for respiratory assistance by mechanical ventilation”.
A quarter of patients treated with anakinra have been transferred to intensive care or have died, compared to almost 73% of those who have not had this biotherapy. The comparison group consisted of 44 patients who had previously been treated in the same institution. In the group receiving anakinra, a rapid decrease in oxygen requirements was also observed after 7 days of treatment.
“Anakinra gives hope”
“In the absence of access to therapeutic trials including immunomodulatory drugs for our patients, the decision (…) taken to offer anakinra, according to severity criteria decided by consensus and a priori, quickly changed the face of indoor illness, “says Professor Jean-Jacques Mourad, co-signatory of the study. “The profit was ‘palpable’ every day,” he said. “There are currently a dozen clinical trials exploring the blockage of cytokine IL-1 associated with Covid-19 inflammatory storm syndrome,” writes Dr. Randy Cron.
Three small case series (including one Italian) have reported that anakinra benefits patients with Covid-19. “But this study provides the most convincing evidence to date that anakinra can benefit patients with cytokine storm syndrome associated with Covid-19,” he said. “Pending controlled trial results, anakinra offers hope for those severely affected by Covid-19,” said Dr. Cron.