suPAR-guided anakinra decreases SRF and restores the pro-/anti-inflammatory balance

Wed Mar 10 2021

An open label trial of anakinra to prevent respiratory failure in COVID-19

The management of pneumonia caused by SARS-CoV-2 should rely on early recognition of the risk for progression to severe respiratory failure (SRF) and its prevention.

The authors investigated if early suPAR -guided anakinra treatment could prevent COVID-19-associated SRF.

The study examined the use of early suPAR-guided anakinra treatment to prevent severe respiratory failure (SRF) in COVID-19 patients. Researchers assigned 30 patients with suPAR levels of 6 ng/ml or higher to receive 100mg of subcutaneous anakinra daily for 10 days. They aimed to see if this treatment could reduce the incidence of SRF by day 14, which they defined as a need for mechanical or non-invasive ventilation due to a respiratory ratio below 150 mmHg. They also looked at secondary outcomes like 30-day mortality and inflammation levels, and compared these results against patients receiving standard care matched by propensity scores.

The study found that anakinra significantly lowered the risk of SRF by 72% in COVID-19 patients admitted with lower respiratory tract infections (LRTI) and suPAR levels above 6μg/l. Patients who received anakinra and were admitted to the ICU also had shorter stays compared to those who did not receive anakinra, indicating lasting benefits of the treatment. This was further supported by a noticeable reduction in 30-day mortality rates.

The authors propose a novel strategy using suPAR as an early biomarker that can effectively identify those patients at high risk of SRF.

They conclude that early suPAR-guided anakinra treatment is associated with a decrease of the risk for severe respiratory failure in COVID-19 patients and restoration of the pro- /anti-inflammatory balance.

Early suPAR-guided anakinra treatment is associated with a decreased risk for SRF and the restoration of the pro- /anti-inflammatory balance.

Kyriazopoulou, E, et al. eLife, 2021


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