Lancet respir med:阿那白滞素不能改善轻中度新冠肺炎患者临床症状

2021-01-25 MedSci原创 MedSci原创

阿那白滞素对轻中度新冠肺炎患者症状改善作用不显著

统计发现,新冠肺炎患者中,大约10-15%的患者为中度或重度疾病,需要入院和吸氧,而3-5%的患者需进行重症监护 (ICU)治疗。过度的炎症反应及大量的细胞因子释放导致的"炎症风暴"是新冠肺炎患者不良预后的重要因素,其中白细胞介素-1(IL-1)是重要的炎症因素。近日研究人员考察了重组IL-1拮抗剂阿那白滞素(anakinra)对轻中度新冠肺炎患者的临床效果
 
CORIMUNO-ANA-1研究为多中心,随机研究,在法国16个医疗中心开展,PCR确诊的新冠肺炎患者参与,临床分类为轻中度,接受3 L/min面罩或鼻套管吸氧,C反应蛋白水平超过25mg/L,不符合ICU治疗标准。患者在标准护理基础上,随机接受阿那白滞素(在第1-3天,每天2次,每次200mg,在第4天剂量调整为100mg,每日2次,在第5天为100mg,每天1次)或安慰剂。研究的主要终点为第4天死亡或需要无创或机械通气(WHO-CPS超过5分)患者比例,以及第14天无需无创或机械通气存活的患者比例。
 
116名患者参与研究,其中阿那白滞素组59人,安慰剂组57人,患者平均年龄66岁,男性占70%。阿那白滞素组59名患者中,21人在第4天WHO-CPS评分超过5分,而安慰剂组55人中,21人(36% vs 38%)。在第14天,阿那白滞素组28名患者需要机械通气或死亡,而安慰剂组28人(47% vs 51%)。第90天,阿那白滞素组16人死亡,而安慰剂组15人(27% vs 27%)。阿那白滞素组严重不良事件率为46%,安慰剂组为38%。
 
研究认为,阿那白滞素对轻中度新冠肺炎患者症状改善作用不显著
 
原始出处:
 
The CORIMUNO-19 Collaborative group. Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial. Lancet respir med. January 22, 2021.

 

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    2021-04-21 howi
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    2021-01-25 公卫新人

    新冠肺炎,疫情何时才能消失

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    2021-01-25 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

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