@article{3031322,
    title = "Early treatment of COVID-19 with anakinra guided by soluble urokinase
plasminogen receptor plasma levels: a double-blind, randomized
controlled phase 3 trial",
    author = "Kyriazopoulou, Evdoxia and Poulakou, Garyfallia and Milionis, Haralampos and and Metallidis, Simeon and Adamis, Georgios and Tsiakos, Konstantinos and and Fragkou, Archontoula and Rapti, Aggeliki and Damoulari, Christina and and Fantoni, Massimo and Kalomenidis, Ioannis and Chrysos, Georgios and and Angheben, Andrea and Kainis, Ilias and Alexiou, Zoi and Castelli, and Francesco and Serino, Francesco Saverio and Tsilika, Maria and Bakakos, and Petros and Nicastri, Emanuele and Tzavara, Vassiliki and Kostis, and Evangelos and Dagna, Lorenzo and Koufargyris, Panagiotis and Dimakou, and Katerina and Savvanis, Spyridon and Tzatzagou, Glykeria and Chini, Maria and and Cavalli, Giulio and Bassetti, Matteo and Katrini, Konstantina and and Kotsis, Vasileios and Tsoukalas, George and Selmi, Carlo and Bliziotis, and Ioannis and Samarkos, Michael and Doumas, Michael and Ktena, Sofia and and Masgala, Aikaterini and Papanikolaou, Ilias and Kosmidou, Maria and and Myrodia, Dimitra-Melia and Argyraki, Aikaterini and Cardellino, Chiara and Simona and Koliakou, Katerina and Katsigianni, Eleni-Ioanna and Rapti, and Vassiliki and Giannitsioti, Efthymia and Cingolani, Antonella and Micha, and Styliani and Akinosoglou, Karolina and Liatsis-Douvitsas, Orestis and and Symbardi, Styliani and Gatselis, Nikolaos and Mouktaroudi, Maria and and Ippolito, Giuseppe and Florou, Eleni and Kotsaki, Antigone and Netea, and Mihai G. and Eugen-Olsen, Jesper and Kyprianou, Miltiades and and Panagopoulos, Periklis and Dalekos, George N. and and Giamarellos-Bourboulis, Evangelos J.",
    journal = "Journal of Natural Medicines",
    year = "2021",
    volume = "27",
    number = "10",
    pages = "1752+",
    publisher = "NATURE PORTFOLIO",
    issn = "1861-0293",
    doi = "10.1038/s41591-021-01499-z",
    abstract = "Early increase of soluble urokinase plasminogen activator receptor
(suPAR) serum levels is indicative of increased risk of progression of
coronavirus disease 2019 (COVID-19) to respiratory failure. The
SAVE-MORE double-blind, randomized controlled trial evaluated the
efficacy and safety of anakinra, an IL-1 alpha/beta inhibitor, in 594
patients with COVID-19 at risk of progressing to respiratory failure as
identified by plasma suPAR >= 6 ng ml(-1), 85.9% (n = 510) of whom were
receiving dexamethasone. At day 28, the adjusted proportional odds of
having a worse clinical status (assessed by the 11-point World Health
Organization Clinical Progression Scale (WHO-CPS)) with anakinra, as
compared to placebo, was 0.36 (95% confidence interval 0.26-0.50). The
median WHO-CPS decrease on day 28 from baseline in the placebo and
anakinra groups was 3 and 4 points, respectively (odds ratio (OR) =
0.40, P < 0.0001); the respective median decrease of Sequential Organ
Failure Assessment (SOFA) score on day 7 from baseline was 0 and 1
points (OR = 0.63, P = 0.004). Twenty-eight-day mortality decreased
(hazard ratio = 0.45, P = 0.045), and hospital stay was shorter.
The SAVE-MORE phase 3 study demonstrates the efficacy of anakinra, an
IL-1 alpha/beta inhibitor, in patients with COVID-19 and high serum
levels of soluble plasminogen activator receptor."
}