An arthritis drug may improve the condition of critically ill coronavirus patients, a new small study suggests.
Researchers found that more than 70 percent treated with anakinra, sold under the brand name Kineret, showed improved breathing and reduced signs of inflammation.
The San Raffaele Hospital team in Milan, Italy, says the findings are the first to suggest that the drug works, but that randomized controlled trials are needed to fully understand the effectiveness of the medication.
Scientists race to test both existing drugs and experimental therapies in hopes that something will change the course of the global pandemic.
In the case of anakinra, experts say that while the results of the study are interesting, it’s far too early to tell whether the drug is working or not.
Researchers tested 29 Italian coronavirus patients with anakinra (pictured), an arthritis drug, and compared them to 16 control patients
In the study, 72% showed improved respiratory health and reduced signs of cytokine storms, which occur when the body attacks not only the virus, but also its own cells. Pictured: A man arrives by ambulance from a New York City hospital on April 25
In the control groups, respiratory function improved for only half of the patients and 56% survived, compared to 90% of the anakinra group. Pictured: EMS ambulance personnel take Zully, a COVID-19 patient, home by ambulance from Stamford Hospital in Connecticut on April 25
“Until a vaccine is available, we urgently need to find a way to help people survive the most severe symptoms of COVID-19 and to do so without overwhelming the hospital’s intensive care capacity,” said Dr. Lorenzo Dagna, Head of Immunology, Rheumatology, Allergy and Rare Diseases Department at San Raffaele Hospital.
“A treatment that has already undergone rigorous safety testing and is available in sufficient quantities to meet the needs of the current pandemic is ideal.”
Anakinra belongs to a class of medicines called interleukin-1 inhibitors that can help regulate a dangerous overreaction to the virus by the body’s immune system called a cytokine storm.
These so-called storms occur when the body not only fights the virus, but also attacks its own cells and tissues.
For the 21-day study, published in The Lancet Rheumatology, the team observed 45 critically ill COVID-19 patients in San Raffaele.
Of those patients, 29 received standard care – including a CPAP respirator, hydroxychloroquine, and lopinavi / ritonavir (an HIV drug) – as well as anakinra through an IV.
The remaining 16 patients received standard care only, which occurred before the study period.
In nearly three-quarters of the 29 patients – 72 percent – showed improved respiratory health and reduced signs of cytokine storms.
They also have lower levels of serum C-reactive protein, which is made by the liver and sent to the bloodstream in response to inflammation. Survival was 90 percent.
For comparison, the group of 16 had sustained or recurrent increases in serum C-reactive protein levels.
Respiratory function improved for only half of the patients and 56 percent survived.
“Our study is the first to suggest that a high dose of the arthritis drug anakinra may block the immune system overreaction caused by COVID-19,” said Dr. Guilo Cavalli, an internal medicine specialist in San Raffaele.
“The results are interesting and the drug deserves controlled tests in large randomized trials.”
Outside experts say the study’s findings are interesting, but a much larger study is needed.
“This is a quick study conducted under unusual conditions and to get a quick idea of whether this arthritis treatment could be helpful in critically ill patients for whom there is currently no treatment,” said Dr. John R Kirwan, Emeritus Professor of Rheumatic disorders at the University of Bristol in the UK.
“It seems that the patients who received the treatment had a slightly better result, but they were also (on average) eight years younger, and this could just as well have been the explanation.”
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