A group of researchers from Greece found that the drug anakinra, which is used to treat rheumatoid arthritis, was able to improve the lung function in patients suffering from severe COVID-19 disease. The small study followed eight patients who also had secondary hemophagocytic lymphohistiocytosis (sHLH), a condition that is defined by an overactive immune system and organ failure. Of the eight participants, one drastically improved after taking the drug. Seven of the eight patients were on ventilators, and three of those patients died despite being given anakinra.
According to senior study author Evangelos J. Giamarellos-Bourboulis, a professor of internal medicine at the Medical School of the National and Kapodistrian University of Athens, "These data argue that the administration of anakinra may be a viable treatment in severe COVID-19 with sHLH, supporting larger clinical studies to validate this concept.” Anakinra treatment decreased signs of sHLH in ICU COVID-19 patients; all of those patients showed improved respiratory function.
Patients who have severe COVID-19 disease have a 50-65% mortality rate, and the complications of the disease are driven by inflammatory responses, particularly through interleukin 1β (IL-1β) and interleukin 6 (IL-6). Overproduction of IL-1β can cause sHLH, and sHLH can have a mortality rate as high as 67%. Anakinra inhibits IL-1β signaling and has shown to reduce mortality in patients with sHLH by 30%.
The authors believe that anakinra may be able to prevent the progression of lung failure, as well as the need for ventilation in patients suffering from COVID-19 and sHLH. "We believe that anakinra has the potential to improve outcomes in patients with severe COVID-19," says first author George Dimopoulos of the National and Kapodistrian University of Athens. "Larger clinical trials are warranted to validate these results and demonstrate the usefulness of anti-IL-1 therapy when COVID-19 is complicated by sHLH."
The results of the study are published in the journal, Cell Host & Microbe.