一个关于阿纳金拉在严重COVID-19疾病中有用性的元分析
Aliae A R Mohamed Hussein1, Reem Sayad2, Abdelrahman Abdelshafi2
1Pulmonology, Chest Department, Assiut Faculty of Medicine, Assiut, Egypt; Assiut Research Team (ART), Assiut 71515, Egypt.
Cytokine
|August 3, 2023
概括
阿纳金拉,一种联素-1 抑制剂,显著降低了严重的COVID-19患者的死亡率和侵入性机械通风的需要. 这种细胞因子风暴治疗方法看起来很有前途,但需要谨慎使用,特别是在免疫受损的个体中.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- COVID-19呈现出超炎症状况和细胞因子风暴,这些风暴是由IL-6和TNF-α等高水平的促炎媒介驱动的.
- 作为一种Interleukin-1 (IL-1) 抑制剂,Anakinra正在通过向IL-1在细胞因子风暴途径中的作用来探索作为严重COVID-19的辅助疗法.
研究的目的:
- 系统地审查和分析评估阿纳金拉在COVID-19患者中的安全性和有效性的研究.
- 评估阿纳金拉对严重COVID-19的关键临床结果的影响.
主要方法:
- 在PubMed,Cochrane图书馆,Scopus和Web of Science数据库中进行了全面的搜索.
- 包括随机和非随机临床试验,队列研究和涉及使用Anakinra治疗的COVID-19患者的病例系列.
- 使用Review Manager 5.4对23项涉及3179名患者的研究的数据进行了元分析.
主要成果:
- 阿纳金拉显著减少了重症监护室 (ICU) 停留时间 (MD = -0.65,p = 0.04) 和侵入性机械通风的需要 (RR = 0.57,p = 0.004).
- 观察到死亡率的统计显著降低 (RR = 0.80,p = 0.04),以及D-二次数水平的显著下降.
- 在住院时间,无氧日或需要非侵入性机械通风方面没有发现显著差异.
结论:
- 阿纳金拉在降低死亡率和在严重的COVID-19中需要侵入性机械通风方面显示出显著的好处.
- 药物在100毫克以下的剂量被认为是安全的,在严重的病例中可能比轻度或中度病例更有益.
- 建议谨慎使用,特别是在免疫功能受损的患者中,尽管有希望的结果和观察到的D-二次元水平降低.
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