In a study from France, 12 patients in stage 2b or 3 COVID-19 associated pneumonia were treated with i.v. anakinra and compared to 10 patients receiving standard-of-care treatment. Those within the experimental group significantly improved clinically, experienced no deaths, and experienced decreased usage of mechanical ventilation. The main drawback of the study is the small sample size.

Application of Anakinra to Treat Inflammation-Associated Respiratory Failure in COVID-19

A group of patients (n = 29) with moderate-to-severe ARDS and hyperinflammation were given high dose Anakinra (5 mg/kg twice a day) and compared to low dose and non-Anakinra-treated group controls. The experimental group experienced reductions in inflammatory serum C-reactive protein and respiratory function improvement (72%), and five were on mechanical ventilation. Outcomes were significantly improved in the experimental group (p = 0.009). This highlights the potential benefits of Anakinra treatment but will require a randomized control trial for complete verification.

Outcomes among 29 patients at San Raffaele Hospital in Milan, Italty

The drug Anakinra was previously approved for treatment of rheumatoid arthritis. Its action was a recombinant form of the IL-1 Ra receptor makes it a potentially valuable target for the treatment of COVID-19 and its associated inflammation.

- Application of Anakinra to Treat Inflammation-Associated Respiratory Failure in COVID-19

Boston University

The IL-1 family of cytokines regulates production of IL-6, and thus may serve as a potential immunomodulatory therapeutic target. Moreover, high levels of IL-1β and its endogenous antagonist, IL-1 receptor antagonist (IL-1 Ra) are associated with COVID-19 onset. Several existing drugs that block IL-1 signaling such as Anakinra and Canakinumab have been proposed as drug options for SARS-CoV-2 infection.

Blocking IL-1 Signaling

Abdin, S. M., Elgendy, S. M., Alyammahi, S. K., Alhamad, Omar, H. A. (2020). Tackling the cytokine storm in COVID-19, challenges and hopes. https://www.sciencedirect.com/science/article/pii/S0024320520308055

Tackling the cytokine storm in COVID-19, challenges and hopes

Anakinra as a Treatment for COVID-19

The drug Canakinumab is an anti-IL-1β monoclonal antibody and has thus been proposed as a method of blocking the elevated IL-1 signaling.

- Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study

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