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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Int+J+Infect+Dis 2021 ; 105 (ä): 319-325 Nephropedia Template TP
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Effectiveness of anakinra for tocilizumab-refractory severe COVID-19: A single-centre retrospective comparative study #MMPMID33592340
de la Calle C; Lopez-Medrano F; Pablos JL; Lora-Tamayo J; Maestro-de la Calle G; Sanchez-Fernandez M; Fernandez-Ruiz M; Perez-Jacoiste Asin MA; Caro-Teller JM; Garcia-Garcia R; Catalan M; Martinez-Lopez J; Sevillano A; Origuen J; Ripoll M; San Juan R; Lalueza A; de Miguel B; Carretero O; Aguilar F; Gomez C; Paz-Artal E; Bueno H; Lumbreras C; Aguado JM
Int J Infect Dis 2021[Apr]; 105 (ä): 319-325 PMID33592340show ga
OBJECTIVES: A subgroup of patients with SARS-CoV-2 infection was thought to have developed cytokine release syndrome and were treated with tocilizumab; however, a significant percentage of patients evolved. This study aimed to determine the usefulness of anakinra as a rescue treatment for patients with tocilizumab-refractory COVID-19 disease. METHODS: A prospective cohort of patients with COVID-19 pneumonia who received anakinra as salvage therapy after failure of tocilizumab were compared (1:1) with 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 6-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. The 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 in improving the prognosis of patients with tocilizumab-refractory severe COVID-19.