Clinical Research
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Year 2023, Volume: 9 Issue: 3, 169 - 183, 30.10.2023

Abstract

Ethical Statement

Yazarlar arasında çıkar çatışması bulunmamaktadır.

Supporting Institution

Çalışma herhangi bir finansal destek almamıştır.

Thanks

COVID-19 pandemisinde çalışan tüm sağlık profesyonellerine teşekkür ederiz.

References

  • Balkhair A, Al-Zakwani I, Al Busaidi M, et. al.(2021). Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study. Int J Infect Dis, 103:288-296. doi: 10.1016/j.ijid.2020.11.149.
  • Bhattacharyya R, Iyer P, Phua GC, Lee JH. (2020). The Interplay Between Coagulation and Inflammation Pathways in COVID-19-Associated Respiratory Failure: A Narrative Review. Pulm Ther, 6(2),215-231. doi: 10.1007/s41030-020- 00126-5.
  • Cauchois R, Koubi M, Delarbre D, et. al.(2020). Early IL-1 receptor blockade in severe inflammatory respiratory failure complicating COVID-19. Proc Natl Acad Sci U S A, 11;117(32), 18951-18953. doi: 10.1073/pnas.2009017117.
  • Cavalli G, Dinarello CA. (2018). Anakinra Therapy for Non-cancer Inflammatory Diseases. Frontiers in pharmacology, 9,1157.
  • Cavalli, G., De Luca, G., Campochiaro, C., et al. (2020). Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyper-inflammation: a retrospective cohort study. Lancet Rheumatol. https://doi.org/10.1016/S2665-9913(20) 30127-2.
  • Clark, K. E. N., Collas, O., Lachmann, H., Singh, A., Buckley, J., & Bhagani, S. (2020). Safety of intravenous anakinra in COVID-19 with evidence of hyperinflammation, a case series. Rheumatology advances in practice, 4(2), rkaa040.
  • CORIMUNO-19 Collaborative group (2021). Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. The Lancet. Respiratory medicine, 9(3), 295–304.
  • Dimopoulos, G., de Mast, Q., Markou, N., et. a. (2020). Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis. Cell host & microbe, 28(1), 117–123.e1.
  • Eloseily EM, Weiser P, Crayne CB, et al. (2020). Benefit of Anakinra in Treating Pediatric Secondary Hemophagocytic Lymphohistiocytosis. Arthritis & Rheumatology, 72(2), 326-334
  • Guan, W.J., Ni, Z.Y., Hu, Y., Liang, W.H., Ou, C.Q., He, J.X., Liu, L., Shan, H., Lei, C.L., Hui, D.S.C., et al.; China Medical Treatment Expert Group for Covid- 19 (2020). Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med, 382, 1708–1720.
  • Henderson LA, Canna SW, Schulert GS, Volpi S, Lee PY, Kernan KF, et al. (2020). On the alert for cytokine storm: immunopathology in COVID-19 [published online ahead of print April 15, 2020, Arthritis Rheumatol, https://doi. org/10.1002/art. 41285.
  • Iglesias-Julián E, López-Veloso M, de-la-Torre-Ferrera N, et.al.(2020). High dose subcutaneous Anakinra to treat acute respiratory distress syndrome secondary to cytokine storm syndrome among severely ill COVID-19 patients. J Autoimmun, 115:102537.
  • Langer-Gould A, Smith JB, Gonzales EG, Castillo RD, Figueroa JG, Ramanathan A, Li BH, Gould MK. (2020). Early identification of COVID-19 cytokine storm and treatment with anakinra or tocilizumab. Int J Infect Dis, 99:291-297. doi: 10.1016/j.ijid.2020.07.081.
  • Monteagudo, L. A., Boothby, A., & Gertner, E. (2020). Continuous Intravenous Anakinra Infusion to Calm the Cytokine Storm in Macrophage Activation Syndrome. ACR open rheumatology, 2(5), 276–282.
  • Navarro-Millán I, Sattui SE, Lakhanpal A, Zisa D, Siegel CH, Crow MK. (2020) Use of Anakinra to Prevent Mechanical Ventilation in Severe COVID-19: A Case Series. Arthritis Rheumatol, 72(12):1990-1997. doi: 10.1002/art.41422.
  • Pontali E, Volpi S, Antonucci G, et. al. (2020). Safety and efficacy of early highdose IV anakinra in severe COVID-19 lung disease. J Allergy Clin Immunol, 146(1):213-215. doi: 10.1016/j.jaci.2020.05.002.
  • Pontali E, Volpi S, Signori A, et. al.(2021). Efficacy of early anti-inflammatory treatment with high doses of intravenous anakinra with or without glucocorticoids in patients with severe COVID-19 pneumonia. J Allergy Clin Immunol, 147(4):1217-1225. doi: 10.1016/j.jaci.2021.01.024.
  • Quartier P, Allantaz F, Cimaz R, et al. (2011). A multicentre, randomised, doubleblind, placebo controlled trial with the interleukin-1 receptor antagonist anakinra in patients with systemic onset juvenile idiopathic arthritis (ANAJIS trial). Ann Rheum Dis, 70(5), 747-754
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. (2020) .Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet,395,1054-62.

COVID-19 Hastalarında Düşük Ve Yüksek Doz Anakinra Kullanımının Mortalite Üzerine Etkisinin Karşılaştırılması

Year 2023, Volume: 9 Issue: 3, 169 - 183, 30.10.2023

Abstract

Amaç: COVID-19'ün ciddi komplikasyonlarından korunmada enflamasyon düzenlemesinin önemli bir rol oynadığı, IL-1/IL-6 yolaklarının merkezi rol oynadığı bilinmektedir. Anakinra, rekombinant bir IL-1 reseptör antagonistidir ve COVID-19 hastalarının tedavisinde kullanılmıştır. Çalışmamızda düşük doz ve yüksek doz anakinra kullanan hastalar retrospektif olarak değerlendirilmesi amaçlandı.
Çalışmamızın primer amacı gruplar arasında 28 günlük mortalite oranlarını karşılaştırmaktır, Sekonder amaçlarımız ise yoğun bakım yatış gün sayısı, mekanik ventilasyon gün sayısı ve akut faz reaktanları (C-reaktif protein, D-Dimer, Ferritin, fibrinojen, AST, LDH, lenfosit gibi) üzerine etkisi değerlendirmektir.
Metod: Düşük doz ve yüksek doz anakinra kullanan 42 hastanın 28 günlük mortalite oranları, yoğun bakım yatış gün sayısı, mekanik ventilasyon gün sayısı ve akut faz reaktanları karşılaştırıldı.
Bulgular: Gruplar arasında yaşayan ve ölen hasta sayıları benzerdi. Lökosit ve Hemoglobin dışındaki değerler, hem iki grup arasında hem her iki grup içinde başlangıç ve yedinci gün arasındaki değişim değerlendirildiğinde benzer bulunmuştur.
Sonuç: Sonuç olarak çalışmamızda yüksek doz ve düşük doz anakinra kullanan hastalar karşılaştırılmış her iki tedavi yöntemi ile benzer mortalite oranları görülmüş akut faz reaktanlarında değişimler hemoglobin ve lökosit dışında her iki grupta da benzer bulunmuştur.

References

  • Balkhair A, Al-Zakwani I, Al Busaidi M, et. al.(2021). Anakinra in hospitalized patients with severe COVID-19 pneumonia requiring oxygen therapy: Results of a prospective, open-label, interventional study. Int J Infect Dis, 103:288-296. doi: 10.1016/j.ijid.2020.11.149.
  • Bhattacharyya R, Iyer P, Phua GC, Lee JH. (2020). The Interplay Between Coagulation and Inflammation Pathways in COVID-19-Associated Respiratory Failure: A Narrative Review. Pulm Ther, 6(2),215-231. doi: 10.1007/s41030-020- 00126-5.
  • Cauchois R, Koubi M, Delarbre D, et. al.(2020). Early IL-1 receptor blockade in severe inflammatory respiratory failure complicating COVID-19. Proc Natl Acad Sci U S A, 11;117(32), 18951-18953. doi: 10.1073/pnas.2009017117.
  • Cavalli G, Dinarello CA. (2018). Anakinra Therapy for Non-cancer Inflammatory Diseases. Frontiers in pharmacology, 9,1157.
  • Cavalli, G., De Luca, G., Campochiaro, C., et al. (2020). Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyper-inflammation: a retrospective cohort study. Lancet Rheumatol. https://doi.org/10.1016/S2665-9913(20) 30127-2.
  • Clark, K. E. N., Collas, O., Lachmann, H., Singh, A., Buckley, J., & Bhagani, S. (2020). Safety of intravenous anakinra in COVID-19 with evidence of hyperinflammation, a case series. Rheumatology advances in practice, 4(2), rkaa040.
  • CORIMUNO-19 Collaborative group (2021). Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. The Lancet. Respiratory medicine, 9(3), 295–304.
  • Dimopoulos, G., de Mast, Q., Markou, N., et. a. (2020). Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis. Cell host & microbe, 28(1), 117–123.e1.
  • Eloseily EM, Weiser P, Crayne CB, et al. (2020). Benefit of Anakinra in Treating Pediatric Secondary Hemophagocytic Lymphohistiocytosis. Arthritis & Rheumatology, 72(2), 326-334
  • Guan, W.J., Ni, Z.Y., Hu, Y., Liang, W.H., Ou, C.Q., He, J.X., Liu, L., Shan, H., Lei, C.L., Hui, D.S.C., et al.; China Medical Treatment Expert Group for Covid- 19 (2020). Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med, 382, 1708–1720.
  • Henderson LA, Canna SW, Schulert GS, Volpi S, Lee PY, Kernan KF, et al. (2020). On the alert for cytokine storm: immunopathology in COVID-19 [published online ahead of print April 15, 2020, Arthritis Rheumatol, https://doi. org/10.1002/art. 41285.
  • Iglesias-Julián E, López-Veloso M, de-la-Torre-Ferrera N, et.al.(2020). High dose subcutaneous Anakinra to treat acute respiratory distress syndrome secondary to cytokine storm syndrome among severely ill COVID-19 patients. J Autoimmun, 115:102537.
  • Langer-Gould A, Smith JB, Gonzales EG, Castillo RD, Figueroa JG, Ramanathan A, Li BH, Gould MK. (2020). Early identification of COVID-19 cytokine storm and treatment with anakinra or tocilizumab. Int J Infect Dis, 99:291-297. doi: 10.1016/j.ijid.2020.07.081.
  • Monteagudo, L. A., Boothby, A., & Gertner, E. (2020). Continuous Intravenous Anakinra Infusion to Calm the Cytokine Storm in Macrophage Activation Syndrome. ACR open rheumatology, 2(5), 276–282.
  • Navarro-Millán I, Sattui SE, Lakhanpal A, Zisa D, Siegel CH, Crow MK. (2020) Use of Anakinra to Prevent Mechanical Ventilation in Severe COVID-19: A Case Series. Arthritis Rheumatol, 72(12):1990-1997. doi: 10.1002/art.41422.
  • Pontali E, Volpi S, Antonucci G, et. al. (2020). Safety and efficacy of early highdose IV anakinra in severe COVID-19 lung disease. J Allergy Clin Immunol, 146(1):213-215. doi: 10.1016/j.jaci.2020.05.002.
  • Pontali E, Volpi S, Signori A, et. al.(2021). Efficacy of early anti-inflammatory treatment with high doses of intravenous anakinra with or without glucocorticoids in patients with severe COVID-19 pneumonia. J Allergy Clin Immunol, 147(4):1217-1225. doi: 10.1016/j.jaci.2021.01.024.
  • Quartier P, Allantaz F, Cimaz R, et al. (2011). A multicentre, randomised, doubleblind, placebo controlled trial with the interleukin-1 receptor antagonist anakinra in patients with systemic onset juvenile idiopathic arthritis (ANAJIS trial). Ann Rheum Dis, 70(5), 747-754
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. (2020) .Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet,395,1054-62.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Health Services and Systems (Other)
Journal Section Articles
Authors

Döndü Genç Moralar 0000-0002-4229-4903

Ülkü Aygen Türkmen 0000-0002-7280-6420

Osman Çelik 0000-0003-4325-840X

Zuhal Çavuş 0000-0002-7588-5240

Serpil Şehirlioğlu This is me 0000-0003-1471-1340

Veysel Dinç 0000-0003-2718-5212

Publication Date October 30, 2023
Submission Date September 4, 2023
Acceptance Date September 18, 2023
Published in Issue Year 2023 Volume: 9 Issue: 3

Cite

APA Genç Moralar, D., Türkmen, Ü. A., Çelik, O., Çavuş, Z., et al. (2023). COVID-19 Hastalarında Düşük Ve Yüksek Doz Anakinra Kullanımının Mortalite Üzerine Etkisinin Karşılaştırılması. Aydın Sağlık Dergisi, 9(3), 169-183.

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