Case Report: Canakinumab for the Treatment of a Patient With COVID-19 Acute Respiratory Distress Syndrome

Caracciolo, Massimo; Macheda, Sebastiano; Labate, Demetrio; Tescione, Marco; Scala, Stefano La; Vadalà, Eugenio; Squillaci, Rosalba; D’Aleo, Francesco; Morabito, Antonella; Garreffa, Cristina; Marciano, Maria Concetta; Oliva, Esther N

doi:10.3389/fimmu.2020.01942

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…Additional therapies such as anti-IL1β, Canakinumab and Janus kinase inhibitors (JAK) −1/2 (Baricitinib and Ruxolitinib) have been tried out. However, to date, there is insufficient data to support their use ( 30 , 31 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Caracciolo¹,

Correale²,

Mangano³

et al. 2021

Front. Immunol.

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Lack of specific antiviral treatment for COVID-19 has resulted in long hospitalizations and high mortality rate. By harnessing the regulatory effects of adenosine on inflammatory mediators, we have instituted a new therapeutic treatment with inhaled adenosine in COVID-19 patients, with the aim of reducing inflammation, the onset of cytokine storm, and therefore to improve prognosis. The use of inhaled adenosine in COVID19 patients has allowed reduction of length of stay, on average 6 days. This result is strengthened by the decrease in SARS-CoV-2 positive days. In treated patients compared to control, a clear improvement in PaO2/FiO2 was observed together with a reduction in inflammation parameters, such as the decrease of CRP level. Furthermore, the efficacy of inhaled exogenous adenosine led to an improvement of the prognosis indices, NLR and PLR. The treatment seems to be safe and modulates the immune system, allowing an effective response against the viral infection progression, reducing length of stay and inflammation parameters.

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Section: Introductionmentioning

confidence: 99%

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Caracciolo¹,

Correale²,

Mangano³

et al. 2021

Front. Immunol.

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“…Canakinumab is an anti‐IL‐1β monoclonal antibody which binds and neutralizes human IL‐1β. Studies examining the ability of canakinumab to improve COVID‐19 disease are currently underway 43,44 . IL‐1β has also been implicated in the development of a number of respiratory diseases such as chronic obstructive pulmonary disease, silicosis and idiopathic pulmonary fibrosis 45,46 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies examining the ability of canakinumab to improve COVID‐19 disease are currently underway. 43 , 44 IL‐1β has also been implicated in the development of a number of respiratory diseases such as chronic obstructive pulmonary disease, silicosis and idiopathic pulmonary fibrosis. 45 , 46 In summary, our preclinical study indicates the therapeutic strategy of targeting IL‐1β during severe IAV infection and this warrants future clinical investigation.…”

Section: Discussionmentioning

confidence: 99%

Interleukin‐1β exacerbates disease and is a potential therapeutic target to reduce pulmonary inflammation during severe influenza A virus infection

Bawazeer

Rosli

Harpur

et al. 2021

Immunol. Cell Biol.

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Hyperinflammatory responses including the production of NLRP3‐dependent interleukin (IL)‐1β is a characteristic feature of severe and fatal influenza A virus (IAV) infections. The NLRP3 inflammasome has been shown to play a temporal role during severe IAV immune responses, with early protective and later detrimental responses. However, the specific contribution of IL‐1β in modulating IAV disease in vivo is currently not well defined. Here, we identified that activation of NLRP3‐dependent IL‐1β responses occurs rapidly following HKx31 H3N2 infection, prior to the onset of severe IAV disease. Mature IL‐1β was detectable in vivo in both hemopoietic and nonhemopoietic cells. Significantly, therapeutic inhibition of IL‐1β in the airways with intranasal anti‐IL‐1β antibody treatment from day 3 postinfection, corresponding to the onset of clinical signs of disease, significantly prolonged survival and reduced inflammation in the airways. Importantly, early targeting of IL‐1β from day 1 postinfection also improved survival. Together, these studies specifically define a role for IL‐1β in contributing to the development of hyperinflammation and disease and indicate that targeting IL‐1β is a potential therapeutic strategy for severe IAV infections.

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“…Canakinumab is human anti-IL-1β monoclonal antibody which works to neutralize 1β signaling [ 119 ]. One case was reported on an elderly COVID-19 patient with ARDS who used canakinumab and resulted in significant reduction in high IL-6 levels and NK cells expressing CD56bright (associated with cytokine release) [ 120 ].…”

Section: Immune-based Therapymentioning

confidence: 99%

COVID-19 Treatment Guidelines: Do They Really Reflect Best Medical Practices to Manage the Pandemic?

Jirjees

Saad

Hano

et al. 2021

Infectious Disease Reports

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SARS-CoV-2 (COVID-19) has been changing the world since December 2019. A comprehensive search into many COVID-19 treatment guidelines was conducted and reported in this article. This is a review paper to probe differences in COVID-19 managing strategies and explore the most common treatment plans among countries. Published guidelines from 23 countries and three references guidelines—until the end of 2020—were included in this article. The majority of COVID-19 treatment options were reported in this review and it includes antiviral drugs, antimalarial drugs, antibiotics, corticosteroids, immunotherapy, anticoagulants, and other pharmacological treatment. The presence of such information from different countries in a single comprehensive review article could help in understanding and speculation of variation in the recommended treatment in each country. This might be related to the cost of medications, the access to the medications, availability of medication that could potentially be useful in managing COVID-19 cases, and the availability/capacity of healthcare facilities. Finally, although there are various treatment groups listed in the published therapeutic guidelines worldwide, unfortunately, there is no evidence for effectiveness of most of these medications in reducing the COVID-19 mortality curve over more than one year of this global pandemic.

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Case Report: Canakinumab for the Treatment of a Patient With COVID-19 Acute Respiratory Distress Syndrome

Cited by 19 publications

References 25 publications

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Interleukin‐1β exacerbates disease and is a potential therapeutic target to reduce pulmonary inflammation during severe influenza A virus infection

COVID-19 Treatment Guidelines: Do They Really Reflect Best Medical Practices to Manage the Pandemic?

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