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Anakinra or tocilizumab in patients admitted to hospital with severe covid-19 at high risk of deterioration (IMMCoVA): A randomized, controlled, open-label trial

Sundén-Cullberg, Jonas (författare)
Karolinska Institutet,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden.
Chen, Puran (författare)
Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Dept Med Huddinge, Ctr Infect Med, Stockholm, Sweden.
Häbel, Henrike (författare)
Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Inst Environm Med, Div Biostat, Stockholm, Sweden.
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Skorup, Paul (författare)
Uppsala universitet,Infektionsmedicin
Janols, Helena (författare)
Uppsala universitet,Infektionsmedicin
Rasmuson, Johan, 1977- (författare)
Umeå universitet,Institutionen för klinisk mikrobiologi,Infection and Immunology, Department of Clinical Microbiology, Umeå University, Umeå, Sweden,Umeå Univ, Dept Clin Microbiol, Infect & Immunol, Umeå, Sweden.
Niward, Katarina, 1971- (författare)
Linköpings universitet,Medicinska fakulteten,Avdelningen för inflammation och infektion,Region Östergötland, Infektionskliniken i Östergötland,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden,Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden.
Östholm Balkhed, Åse, 1972- (författare)
Linköpings universitet,Medicinska fakulteten,Avdelningen för inflammation och infektion,Region Östergötland, Infektionskliniken i Östergötland,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden,Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden.
Chatzidionysiou, Katerina (författare)
Rheumatology Division, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden,Karolinska Inst, Karolinska Univ Hosp, Div Rheumatol, Dept Med Solna, Stockholm, Sweden.
Asgeirsson, Hilmir (författare)
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden.
Blennow, Ola (författare)
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden.
Parke, Åsa (författare)
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden.
Svensson, Anna-Karin (författare)
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden.
Muvva, Jagadeeswara Rao (författare)
Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Dept Med Huddinge, Ctr Infect Med, Stockholm, Sweden.
Ljunggren, Hans-Gustav (författare)
Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Dept Med Huddinge, Ctr Infect Med, Stockholm, Sweden.
Horne, Anna-Carin (författare)
Karolinska Institutet,Karolinska Univ Hosp, Theme Childrens & Womens Hlth, Stockholm, Sweden.
Ådén, Ulrika (författare)
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
Henter, Jan-Inge (författare)
Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Dept Womens & Childrens Hlth, Childhood Canc Res Unit, Stockholm, Sweden.
Sönnerborg, Anders (författare)
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Dept Microbiol Tumor & Cell Biol, Stockholm, Sweden.
Vesterbacka, Jan (författare)
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden.
Nowak, Piotr (författare)
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden,Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden.
Lampa, Jon (författare)
Rheumatology Division, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden,Karolinska Inst, Karolinska Univ Hosp, Div Rheumatol, Dept Med Solna, Stockholm, Sweden.
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Karolinska Institutet Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden;Karolinska Inst, Div Infect Dis, Dept Med Huddinge, Stockholm, Sweden. (creator_code:org_t)
Public Library of Science (PLoS), 2023
2023
Engelska.
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:12
Relaterad länk:
https://doi.org/10.1...
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https://urn.kb.se/re...
https://doi.org/10.1...
https://urn.kb.se/re...
http://kipublication...
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https://urn.kb.se/re...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Background: Anakinra and tocilizumab are used for severe Covid-19, but only one previous randomized controlled trial (RCT) has studied both. We performed a multi-center RCT comparing anakinra or tocilizumab versus usual care (UC) for adults at high risk of deterioration.Methods: The study was conducted June 2020 to March 2021. Eligibility required ≥ 5 liters/minute of Oxygen to maintain peripheral oxygen saturation at ≥ 93%, CRP > 70 mg/L, ferritin > 500 μg/L and at least two points where one point was awarded for lymphocytes < 1x 109/L; D-dimer ≥ 0.5 mg/L and; lactate dehydrogenase ≥ 8 microkatal/L. Patients were randomly assigned 1:1:1 to receive either a single dose of tocilizumab (8 mg/kg) or anakinra 100 mg IV QID for seven days or UC alone. The primary outcome was time to recovery.Results: Recruitment was ended prematurely when tocilizumab became part of usual care. Out of a planned 195 patients, 77 had been randomized, 27 to UC, 28 to anakinra and 22 to tocilizumab. Median time to recovery was 15, 15 and 11 days. Rate ratio for recovery for UC vs anakinra was 0.91, 0.47 to 1.78, 95% [CI], p = 0.8 and for UC vs tocilizumab 1.13, 0.55 to 2.30; p = 0.7. There were non-significant trends favoring tocilizumab (and to limited degree anakinra) vs UC for some secondary outcomes. Safety profiles did not differ significantly.Conclusion: Premature closure of trial precludes firm conclusions. Anakinra or tocilizumab did not significantly shorten time to clinical recovery compared to usual care. (IMMCoVA, NCT04412291, EudraCT: 2020-00174824).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Immunology in the medical area (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

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