Wed Feb 03 2021

suPAR-guided Anakinra treatment decreases risk for severe respiratory failure for COVID-19 patients

A recent study by Prof. Giamarellos and colleagues, published on the preprint server medRxiv and under peer review, shows that suPAR levels of 6 ng/mL or higher can effectively pinpoint patients at a high risk for Severe Respiratory Failure (SRF). Treating these high-risk patients with Anakinra significantly cuts the incidence of SRF.

suPAR-guided Anakinra treatmentThe study involved 260 patients, all with suPAR levels of 6 ng/mL or above. Half received Anakinra treatment, while the other half, serving as matched controls, did not.

Findings reveal that Anakinra treatment reduced the SRF rate to 22.3% from 59.2% in the untreated group. The 30-day mortality rates were 11.5% for treated patients compared to 22.3% for those untreated.

The study suggests using suPAR levels at admission for COVID-19 patient triage. This approach enables the early detection and treatment of those at high risk of respiratory failure, significantly lowering the need for mechanical ventilation and the risk of SRF with Anakinra treatment.


Using a suPAR cut-off value of 6 ng/ ml for triage of COVID-19 patients allows early treatment of Anakinra and reduces the risk of developing SRF with ~40%.

SAVE is the most promising strategy against COVID-19. Our data confirm that:

  • suPAR ≥6ng/ml recognizes early the patients at risk for respiratory failure.
  • Start of anakinra once increased suPAR is detected prevents mechanical ventilation and decreases 30-day mortality
  • The duration and cost of hospitalization decrease

Prof. E. J. Giamarellos-Bourboulis, MD, PhD

1. Anakinra To Prevent Respiratory Failure In COVID-19. Kyriazopoulou et al.

2. Anakinra is an interleukin antagonist which is an FDA approved biopharmaceutical drug used to treat rheumatoid arthritis.

3. Soluble Urokinase Plasminogen Activator Receptor: A Biomarker for Predicting Complications and Critical Care Admission of COVID-19 Patients. Chalkias A, Mouzarou A, Samara E, Xanthos T, Ischaki E, Pantazopoulos I.Mol Diagn Ther. 2020 Oct;24(5):517-521.

4. COVID-19 and pneumonia: a role for the uPA/uPAR system. D’Alonzo D, De Fenza M, Pavone V.Drug Discov Today. 2020 Aug;25(8):1528-1534.


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