TY - JOUR T1 - Interleukin-6 blockade with sarilumab in severe COVID-19 pneumonia with systemic hyperinflammation: an open-label cohort study JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1277 LP - 1285 DO - 10.1136/annrheumdis-2020-218122 VL - 79 IS - 10 AU - Emanuel Della-Torre AU - Corrado Campochiaro AU - Giulio Cavalli AU - Giacomo De Luca AU - Angela Napolitano AU - Salvatore La Marca AU - Nicola Boffini AU - Valentina Da Prat AU - Gaetano Di Terlizzi AU - Marco Lanzillotta AU - Patrizia Rovere Querini AU - Annalisa Ruggeri AU - Giovanni Landoni AU - Moreno Tresoldi AU - Fabio Ciceri AU - ALberto Zangrillo AU - Francesco De Cobelli AU - Lorenzo Dagna A2 - , Y1 - 2020/10/01 UR - http://ard.bmj.com/content/79/10/1277.abstract N2 - Objectives To assess the safety and efficacy of interleukin (IL)−6 blockade with sarilumab in patients with severe COVID-19 pneumonia and systemic hyperinflammation.Methods We conducted an open-label study of sarilumab in severe COVID-19 pneumonia (PaO2/FiO2 <300 mm Hg) with hyperinflammation (elevated inflammatory markers and serum IL-6 levels). Sarilumab 400 mg was administered intravenously in addition to standard of care and results were compared with contemporary matched patients treated with standard of care alone. Clinical improvement, mortality, safety and predictors of response were assessed at 28 days.Results Twenty-eight patients were treated with sarilumab and 28 contemporary patients receiving standard of care alone were used as controls. At day 28 of follow-up, 61% of patients treated with sarilumab experienced clinical improvement and 7% died. These findings were not significantly different from the comparison group (clinical improvement 64%, mortality 18%; p=NS). Baseline PaO2/FiO2 ratio >100 mm Hg and lung consolidation <17% at CT scan predicted clinical improvement in patients treated with sarilumab. Median time to clinical improvement in patients with lung consolidation <17% was shorter after sarilumab (10 days) than after standard treatment (24 days; p=0.01). The rate of infection and pulmonary thrombosis was similar between the two groups.Conclusions At day 28, overall clinical improvement and mortality in patients with severe COVID-19 were not significantly different between sarilumab and standard of care. Sarilumab was associated with faster recovery in a subset of patients showing minor lung consolidation at baseline. ER -