Author: de la Calle, Cristina; López-Medrano, Francisco; Pablos, José Luis; Lora-Tamayo, Jaime; Calle, Guillermo Maestro-de la; Sánchez-Fernández, Marcos; Fernández-Ruiz, Mario; AsÃn, MarÃa Asunción Pérez-Jacoiste; Caro-Teller, José Manuel; GarcÃa-GarcÃa, RocÃo; Catalán, Mercedes; MartÃnez-López, JoaquÃn; Sevillano, Ãngel; Origüen, Julia; Ripoll, Mar; Juan, Rafael San; Lalueza, Antonio; de Miguel, Borja; Carretero, Octavio; Aguilar, Fernando; Gómez, Carlos; Paz-Artal, Estela; Bueno, Héctor; Lumbreras, Carlos; Aguado, José MarÃa
Title: Effectiveness of anakinra for tocilizumab-refractory severe COVID-19. A single centre retrospective comparative study Cord-id: iv67hm9c Document date: 2021_2_13
ID: iv67hm9c
Snippet: Objetives A subgroup of patients with SARS-CoV-2 infection is considered to develop a cytokine release syndrome and have been treated with tocilizumab, but a significant percentage of patients evolve. Our objective was to determine the usefulness of anakinra as rescue treatment for patients with tocilizumab-refractory COVID-19 disease. Methods A prospective cohort of patients with COVID19 pneumonia who received anakinra as salvage therapy after failure of tocilizumab were compared (1:1) to selec
Document: Objetives A subgroup of patients with SARS-CoV-2 infection is considered to develop a cytokine release syndrome and have been treated with tocilizumab, but a significant percentage of patients evolve. Our objective was to determine the usefulness of anakinra as rescue treatment for patients with tocilizumab-refractory COVID-19 disease. Methods A prospective cohort of patients with COVID19 pneumonia who received anakinra as salvage therapy after failure of tocilizumab were compared (1:1) to selected controls in a historical cohort of patients treated with tocilizumab. Cases and controls were matched by age, comorbidities, pulse oximetry oxygen saturation to fraction of inspired oxygen (SpO2/FiO2) ratio at baseline and time elapsed since the initiation of treatment with tocilizumab. The primary outcome was the improvement in clinical status measured by a six-point ordinal scale, from baseline to day 21. Results The study included 20 cases and 20 controls (mean age 65.3±12.8 years, 65% males). No differences were found in the clinical improvement rates at 7, 14 and 21 days of follow-up. In-hospital mortality rate for patients receiving anakinra was 55% vs. 45% in the control group (P =0.527). Conclusions Treatment with anakinra was not useful to improve the prognosis of patients with tocilizumab-refractory severe COVID-19.
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