Wed Feb 03 2021
suPAR-guided Anakinra treatment decreases risk for severe respiratory failure for COVID-19 patients
A new study by Prof. Giamarellos and co-workers has just been published via the preprint server medRxiv1 . The study is currently undergoing peer review.
The study demonstrates that suPAR levels ≥6 ng/mL can be used as an early biomarker to effectively identify patients at high risk of for Severe Respiratory Failure (SRF). Treatment of these patients with regular doses of Anakinra is associated with a decrease in the incidence of SRF.
The reported data include 130 patients with suPAR levels ≥6 ng/mL undergoing Anakinra2 treatment and 130 matched controls (with suPAR levels ≥6 ng/mL) who did not receive Anakinra treatment.
The incidence of SRF among patients treated with Anakinra was 22.3%. In the control group, the incidence was 59.2%. Mortality after 30 days was 11.5% and 22.3% respectively.
Using admission suPAR levels for triage of COVID-19 patients3,4 can identify COVID-19 patients in high risk of respiratory failure. Early identification and treatment intervention, e.g. using Anakinra, can significantly reduce risk of SRF and need for mechanical ventilation.
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
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.