KEY POINTS

  • Treatment options for critically ill COVID-19 patients treated outside ICUs- need of the hour
  • A recent study demonstrated that arthritis drug anakinra appeared promising
  • The U.S.FDA approved arthritis drug found to be safe and effective in treating ARDS

Rheumatoid Arthritis drug anakinra has been reported to be promising in treating acute respiratory distress syndrome and hyper-inflammation in COVID-19 patients reported a new study. It is the first-ever study to demonstrate the safety and efficacy of an arthritis drug in treating COVID-19.

The study included 29 patients who received standard care of non-invasive ventilation, hydroxychloroquine, and lopinavir/ritonavir alongside the daily high-dose intravenous infusion of the arthritis drug anakinra at 10 mg/kg body weight.

Although this is just an observational study, the findings revealed that the arthritis drug improved lung function in hospitalized COVID-19 patients.

"Our study is the first to suggest that a high dose of the arthritis drug anakinra may be able to block the overreaction of the immune system caused by COVID-19. The results are interesting and the drug deserves controlled testing in large randomized trials," EurekAlert quoted Dr. Giulio Cavalli, from the Unit of Immunology, Rheumatology, Allergy, and Rare Diseases at San Raffaele Hospital and Vita-Salute San Raffaele University, Italy.

The drug anakinra sold by Swedish Orphan Biovitrum AB as Kineret was linked to a 90% survival rate and reduced respiratory symptoms.

Inflammation is considered one of the most harmful effects of COVID-19 and is a protective response to infections and injuries that can turn on the body via a phenomenon called a cytokine storm. Drug manufacturers are currently testing products including Actemra and Kevzara that treat inflammation than the coronavirus infection.

“In the story of host-meets-virus, we tend to focus on the virus. These and other emerging data rightly focus more attention on the host inflammatory response and might herald a shift in how we approach the host-virus relationship,” Bloomberg Law quoted Kate Kernan and Scott Canna of the University of Pittsburgh Medical Center.

ARDS is said to be the main cause of death from COVID-19 and the estimated mortality rates range from 28% to 78%. A COVID-19 patient’s breathing is supported until the inflammation recedes. But the number of patients who require ventilation could exceed the number of mechanical ventilators available. Therefore, treatments to improve the prognosis of critically ill COVID-19 patients treated outside ICUs are the need of the hour.

Anakinra is already approved by the U.S. Food and Drug Administration and the European Medicines Agency to treat rheumatoid arthritis, still’s a disease as well as recurrent fever. The drug works by blocking the proinflammatory cytokine IL-1. The researchers also pointed out that compared to other cytokine-blocking agents, this arthritis drug was safer and was very much suitable for critically ill patients.

“In view of the biological plausibility of anakinra, the pharmacokinetic and safety profile of the drug, and a growing body of positive experience in autoinflammation and cytokine storm, these data are promising and support prioritizing this approach in the planning and enrolment of randomized controlled trials," EurekAlert quoted Dr. Scott Canna from the University of Pittsburgh Medical Center.