RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1277
OP 1285
DO 10.1136/annrheumdis-2020-218122
VO 79
IS 10
A1 Emanuel Della-Torre
A1 Corrado Campochiaro
A1 Giulio Cavalli
A1 Giacomo De Luca
A1 Angela Napolitano
A1 Salvatore La Marca
A1 Nicola Boffini
A1 Valentina Da Prat
A1 Gaetano Di Terlizzi
A1 Marco Lanzillotta
A1 Patrizia Rovere Querini
A1 Annalisa Ruggeri
A1 Giovanni Landoni
A1 Moreno Tresoldi
A1 Fabio Ciceri
A1 ALberto Zangrillo
A1 Francesco De Cobelli
A1 Lorenzo Dagna
A1 ,
YR 2020
UL http://ard.bmj.com/content/79/10/1277.abstract
AB 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.