Blockage of interleukin-1β with canakinumab in patients with Covid-19
Lorenza Landi, Claudia Ravaglia, Emanuele Russo, Pierluigi Cataleta, Maurizio Fusari, Andrea Boschi, Diana Giannarelli, Francesca Facondini, Ilaria Valentini, Ilaria Panzini, Luigi Lazzari-Agli, P. Bassi, Elisa Marchionni, Rossella Romagnoli, Raffaella De Giovanni, Marina Assirelli, Federica Baldazzi, Fabio Pieraccini, Giovanna Rametta, Lucía Rossi, Luca Santini, Ivana Valenti, Federico Cappuzzo
Abstract
Abstract There is the urgent need to study the effects of immunomodulating agents as therapy for Covid-19. An observational, cohort, prospective study with 30 days of observation was carried out to assess clinical outcomes in 88 patients hospitalized for Covid-19 pneumonia and treated with canakinumab (300 mg sc). Median time from diagnosis of Covid-19 by viral swab to administration of canakinumab was 7.5 days (range 0–30, IQR 4–11). Median PaO 2 /FiO 2 increased from 160 (range 53–409, IQR 122–210) at baseline to 237 (range 72–533, IQR 158–331) at day 7 after treatment with canakinumab ( p < 0.0001). Improvement of oxygen support category was observed in 61.4% of cases. Median duration of hospitalization following administration of canakinumab was 6 days (range 0–30, IQR 4–11). At 7 days, 58% of patients had been discharged and 12 (13.6%) had died. Significant differences between baseline and 7 days were observed for absolute lymphocyte counts (mean 0.60 vs 1.11 × 10 9 /L, respectively, p < 0.0001) and C-reactive protein (mean 31.5 vs 5.8 mg/L, respectively, p < 0.0001).Overall survival at 1 month was 79.5% (95% CI 68.7–90.3). Oxygen-support requirements improved and overall mortality was 13.6%. Confirmation of the efficacy of canakinumab for Covid-19 warrants further study in randomized controlled trials.