Objective
The objective of this study was to report the benefit of a therapeutic approach consisting of intravenous (IV) continuous anakinra (recombinant human interleukin‐1 receptor antagonist) infusions in treating severely ill adult patients with secondary hemophagocytic lymphohistiocytosis or macrophage activation syndrome (MAS).
Methods
A retrospective chart review of five patients treated at Regions Hospital from 2016 to 2019 was conducted. Demographic, clinical, and laboratory characteristics and outcomes were recorded.
Results
Continuous IV anakinra infusions up to 2400 mg/d resulted in rapid serologic, then clinical response in 4 of 5 severely ill patients who were refractory to all other therapies, including subcutaneous anakinra. Subsequently, 3 of 5 patients have been maintained on anakinra or canakinumab, with no recurrence of MAS.
Conclusion
Continuous infusion of IV anakinra may result in rapid serologic and subsequent clinical improvement in adult patients with MAS. This method for treating cytokine storm should be considered in the current COVID‐19 pandemic in the subgroup of patients with severe disease who have a cytokine storm presentation.
Twitter, the social media service that permits 140-character posts or "tweets," is undergoing rapid uptake by physicians. 1 Twitter allows physicians to communicate, interpret, highlight, and curate information as well as engage in discussion or debate with other physicians, patients, patient advocates, researchers, investors, and industry employees. More than 60% of tweets authored by medical professionals in the United States are health-related, and approximately 14% mention commercial products or services. 2 Yet, to our knowledge, there has been no investigation of the prevalence of financial conflict of interest (FCOI) among these users.Methods | We constructed a set of hematologist-oncologists who are active on Twitter and have primary affiliations in the United States. We then assessed their FCOIs occurring in 2014. This data set was created in 2 steps. First, we selected 1 hematologistoncologist (who does not have FCOI [V.P.]) and searched all Twitter users who were followed by and was following that physician; this set consisted of approximately 50 people. Second, we used Google to identify hematologist-oncologists with primary Related articles pages 352, 344 and 427
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