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The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis

The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and m...

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Autores principales: Kyriakoulis, Konstantinos G., Kollias, Anastasios, Poulakou, Garyphallia, Kyriakoulis, Ioannis G., Trontzas, Ioannis P., Charpidou, Andriani, Syrigos, Konstantinos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509118/
https://www.ncbi.nlm.nih.gov/pubmed/34640480
http://dx.doi.org/10.3390/jcm10194462
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author Kyriakoulis, Konstantinos G.
Kollias, Anastasios
Poulakou, Garyphallia
Kyriakoulis, Ioannis G.
Trontzas, Ioannis P.
Charpidou, Andriani
Syrigos, Konstantinos
author_facet Kyriakoulis, Konstantinos G.
Kollias, Anastasios
Poulakou, Garyphallia
Kyriakoulis, Ioannis G.
Trontzas, Ioannis P.
Charpidou, Andriani
Syrigos, Konstantinos
author_sort Kyriakoulis, Konstantinos G.
collection PubMed
description The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and meta-analysis regarding the impact of anakinra on the outcomes of hospitalized patients with COVID-19 was conducted. Studies, randomized or non-randomized with adjustment for confounders, reporting on the adjusted risk of death in patients treated with anakinra versus those not treated with anakinra were deemed eligible. A search was performed in PubMed/EMBASE databases, as well as in relevant websites, until 1 August 2021. The meta-analysis of six studies that fulfilled the inclusion criteria (n = 1553 patients with moderate to severe pneumonia, weighted age 64 years, men 66%, treated with anakinra 50%, intubated 3%) showed a pooled hazard ratio for death in patients treated with anakinra at 0.47 (95% confidence intervals 0.34, 0.65). A meta-regression analysis did not reveal any significant associations between the mean age, percentage of males, mean baseline C-reactive protein levels, mean time of administration since symptoms onset among the included studies and the hazard ratios for death. All studies were considered as low risk of bias. The current evidence, although derived mainly from observational studies, supports a beneficial role of anakinra in the treatment of selected patients with COVID-19.
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spelling pubmed-85091182021-10-13 The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis Kyriakoulis, Konstantinos G. Kollias, Anastasios Poulakou, Garyphallia Kyriakoulis, Ioannis G. Trontzas, Ioannis P. Charpidou, Andriani Syrigos, Konstantinos J Clin Med Review The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and meta-analysis regarding the impact of anakinra on the outcomes of hospitalized patients with COVID-19 was conducted. Studies, randomized or non-randomized with adjustment for confounders, reporting on the adjusted risk of death in patients treated with anakinra versus those not treated with anakinra were deemed eligible. A search was performed in PubMed/EMBASE databases, as well as in relevant websites, until 1 August 2021. The meta-analysis of six studies that fulfilled the inclusion criteria (n = 1553 patients with moderate to severe pneumonia, weighted age 64 years, men 66%, treated with anakinra 50%, intubated 3%) showed a pooled hazard ratio for death in patients treated with anakinra at 0.47 (95% confidence intervals 0.34, 0.65). A meta-regression analysis did not reveal any significant associations between the mean age, percentage of males, mean baseline C-reactive protein levels, mean time of administration since symptoms onset among the included studies and the hazard ratios for death. All studies were considered as low risk of bias. The current evidence, although derived mainly from observational studies, supports a beneficial role of anakinra in the treatment of selected patients with COVID-19. MDPI 2021-09-28 /pmc/articles/PMC8509118/ /pubmed/34640480 http://dx.doi.org/10.3390/jcm10194462 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kyriakoulis, Konstantinos G.
Kollias, Anastasios
Poulakou, Garyphallia
Kyriakoulis, Ioannis G.
Trontzas, Ioannis P.
Charpidou, Andriani
Syrigos, Konstantinos
The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis
title The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis
title_full The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis
title_fullStr The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis
title_full_unstemmed The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis
title_short The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis
title_sort effect of anakinra in hospitalized patients with covid-19: an updated systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509118/
https://www.ncbi.nlm.nih.gov/pubmed/34640480
http://dx.doi.org/10.3390/jcm10194462
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