Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.
Department of Medicine and Aging Sciences, Internal Medicine, "G. D'Annunzio" University, Chieti, Italy.
Immun Inflamm Dis. 2021 Jun;9(2):399-405. doi: 10.1002/iid3.400. Epub 2021 Jan 19.
Clinicians all around the world are currently experiencing a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several therapeutic strategies have been used until now but, to date, there is no specific therapy to treat SARS-CoV-2 infection. In this study, we used canakinumab, a human monoclonal antibody targeting interleukin-1 beta to improve respiratory function and laboratory parameters compared with standard therapy (hydroxycloroquine plus lopinavir/ritonavir).
We enrolled 34 patients with mild or severe non intensive care unit (ICU) coronavirus disease 2019 (COVID-19): 17 patients treated with standard therapy and 17 patients treated with a subcutaneous single dose of canakinumab 300 mg. We collected data about oxygen supports and laboratory parameters such as inflammation indices and hemogasanalysis. We compared the data collected before the administration of canakinumab (T0), 3 days after T0 (T1) and 7 days after T0 (T2) with the same data from patients taking the standard therapy.
We observed a reduction in inflammation indices and a significant and rapid increase in P/F ratio in canakinumab group, with improvement of 60.3% after the administration. We reported a significant reduction in oxygen flow in patients treated with canakinumab (-28.6% at T1 vs. T0 and -40.0% at T2 vs. T1). Conversely, the standard group increased the supply of high oxygen at T1 versus T0 (+66.7%), but reduced oxygen flows at T2 versus T1 (-40.0%).
In hospitalized adult patients with mild or severe non ICU COVID-19, canakinumab could be a valid therapeutic option. Canakinumab therapy causes rapid and long-lasting improvement in oxygenation levels in the absence of any severe adverse events.
目前，全世界的临床医生都在经历由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的大流行。迄今为止，已经使用了几种治疗策略，但尚无针对 SARS-CoV-2 感染的特定疗法。在这项研究中，我们使用了靶向白细胞介素-1β的人单克隆抗体卡那单抗，与标准治疗（羟氯喹加洛匹那韦/利托那韦）相比，改善了呼吸功能和实验室参数。
我们纳入了 34 名患有轻度或重度非重症监护病房（ICU）的 2019 年冠状病毒病（COVID-19）患者：17 名接受标准治疗，17 名接受皮下单次 300mg 卡那单抗治疗。我们收集了有关氧支持和实验室参数的数据，如炎症指标和血气分析。我们将接受卡那单抗治疗前（T0）、T0 后 3 天（T1）和 T0 后 7 天（T2）的数据与接受标准治疗的患者的相同数据进行比较。
我们观察到卡那单抗组的炎症指标降低，P/F 比值显著且迅速升高，给药后改善了 60.3%。我们报告说，接受卡那单抗治疗的患者的氧气流量显著减少（T1 与 T0 相比减少 28.6%，T2 与 T1 相比减少 40.0%）。相反，标准组在 T1 与 T0 相比增加了高氧供应（增加 66.7%），但在 T2 与 T1 相比减少了氧气流量（减少 40.0%）。
在患有轻度或重度非 ICU COVID-19 的住院成年患者中，卡那单抗可能是一种有效的治疗选择。卡那单抗治疗可迅速且持久地改善氧合水平，且无任何严重不良事件。
