Rheumatoid arthritis drug shows promising signs on acute patients
The results of a study from 29 Italian patients with Covid-19, acute respiratory distress syndrome, and hyperinflammation indicate that high-dose intravenous treatment with a rheumatoid arthritis drug showed promising results.
The report for use of the drug anakinra found that high-doseage was safe and associated with respiratory improvements and reduced signs of cytokine storm in 72 per cent of patients.
Most people with Covid-19 experience only mild symptoms, but in severely affected patients the immune system overreacts, triggering a storm of immune proteins called cytokines. The cytokines contribute to hyperinflammation, leading to acute respiratory distress syndrome (ARDS) and reducing oxygen levels in the blood.
ARDS is the main cause of death from coronavirus disease. Of patients admitted to intensive care units with Covid-19 and ARDS, the estimated death rate ranges from 28 per cent to 78 per cent.
All 29 patients in a Milan hospital received standard care (of non-invasive ventilation (CPAP), hydroxychloroquine, and lopinavir/ritonavir) as well as the drug treatment.
They were compared to 16 patients who received standard care only.
However, the study was not a randomised controlled trial, which is the gold standard for establishing the effectiveness of a treatment.
Prof Lorenzo Dagna, head of the Unit of Immunology, Rheumatology, Allergy and Rare Diseases at San Raffaele Hospital and Vita-salute San Raffaele University, said: “Until a vaccine is available, we urgently need to find a way to help people survive the most severe symptoms of Covid-19, and to do that without overwhelming the intensive care capacity of hospitals.
“A treatment that has already met strict safety tests and that is available in sufficient quantities to meet the needs of the current pandemic is ideal.”
Dr Giulio Cavalli, said: “Our study is the first to suggest 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 randomised trials.”