Περίληψη:
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.
Συγγραφείς:
Kyriazopoulou, Evdoxia
Poulakou, Garyfallia
Milionis, Haralampos
and Metallidis, Simeon
Adamis, Georgios
Tsiakos, Konstantinos
and Fragkou, Archontoula
Rapti, Aggeliki
Damoulari, Christina
and Fantoni, Massimo
Kalomenidis, Ioannis
Chrysos, Georgios and
Angheben, Andrea
Kainis, Ilias
Alexiou, Zoi
Castelli,
Francesco
Serino, Francesco Saverio
Tsilika, Maria
Bakakos,
Petros
Nicastri, Emanuele
Tzavara, Vassiliki
Kostis,
Evangelos
Dagna, Lorenzo
Koufargyris, Panagiotis
Dimakou,
Katerina
Savvanis, Spyridon
Tzatzagou, Glykeria
Chini, Maria
and Cavalli, Giulio
Bassetti, Matteo
Katrini, Konstantina and
Kotsis, Vasileios
Tsoukalas, George
Selmi, Carlo
Bliziotis,
Ioannis
Samarkos, Michael
Doumas, Michael
Ktena, Sofia and
Masgala, Aikaterini
Papanikolaou, Ilias
Kosmidou, Maria and
Myrodia, Dimitra-Melia
Argyraki, Aikaterini
Cardellino, Chiara
Simona
Koliakou, Katerina
Katsigianni, Eleni-Ioanna
Rapti,
Vassiliki
Giannitsioti, Efthymia
Cingolani, Antonella
Micha,
Styliani
Akinosoglou, Karolina
Liatsis-Douvitsas, Orestis and
Symbardi, Styliani
Gatselis, Nikolaos
Mouktaroudi, Maria and
Ippolito, Giuseppe
Florou, Eleni
Kotsaki, Antigone
Netea,
Mihai G.
Eugen-Olsen, Jesper
Kyprianou, Miltiades and
Panagopoulos, Periklis
Dalekos, George N. and
Giamarellos-Bourboulis, Evangelos J.
