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Interleukin-1 blocking agents for treating COVID-19.

Mauricia Davidson1,2,3, Sonia Menon1, Anna Chaimani1,2

  • 1Cochrane France, Paris, France.

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This summary is machine-generated.

Interleukin-1 (IL-1) blocking agents like anakinra and canakinumab showed no significant benefit for treating severe COVID-19. Further research is needed as evidence for effectiveness and safety remains uncertain for these immunomodulatory treatments.

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Pharmacology

Background:

  • Interleukin-1 (IL-1) blocking agents have been explored for severe COVID-19 due to their immunomodulatory properties.
  • The premise is that modulating the immune response could benefit patients with COVID-19.

Purpose of the Study:

  • To evaluate the effectiveness and safety of IL-1 blocking agents compared to standard care or placebo in COVID-19 patients.
  • To provide an updated assessment of available evidence.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) identified through comprehensive searches of major medical databases and trial registries.
  • Data extraction and risk of bias assessment were performed independently by two researchers using Cochrane methodology.
  • Certainty of evidence was rated using the GRADE approach for critical outcomes including clinical improvement, clinical progression, mortality, and adverse events.

Main Results:

  • Six RCTs (4 anakinra, 2 canakinumab) were included. Anakinra showed little or no increase in clinical improvement at Day 28 (moderate-certainty evidence).
  • Evidence regarding anakinra's effect on clinical progression and all-cause mortality was uncertain or very uncertain.
  • Canakinumab also demonstrated little or no increase in clinical improvement at Day 28, with uncertain evidence for other outcomes. Safety data showed little or no increase in adverse events for both agents.

Conclusions:

  • Current evidence does not support a significant beneficial effect of IL-1 blocking agents for treating COVID-19.
  • The certainty of evidence for many outcomes remains low or very uncertain, necessitating cautious interpretation.
  • Ongoing and completed trials may provide further insights, with results updated on the COVID-NMA platform.