SynthesisEuropean journal of internal medicine2021
Anakinra for patients with COVID-19: a meta-analysis of non-randomized cohort studies.
Synthesis in European journal of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 5 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Effectiveness of pharmacological treatments for COVID-19 due to SARS-CoV-2: a systematic literature review.Frontiers in pharmacology · 2025Pooled it
- Anakinra for the treatment of COVID-19 patients: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Anakinra treatment efficacy in reduction of inflammatory biomarkers in COVID-19 patients: A meta-analysis.Journal of clinical laboratory analysis · 2022Pooled it
- Interleukin-1 blocking agents for treating COVID-19.The Cochrane database of systematic reviews · 2022Pooled it
- The use of complementary and traditional medicine for the treatment of patients with COVID-19: A systematic review.Explore (New York, N.Y.)Pooled it
- Trial
- Navigating Therapeutic Frontiers: A Meta-review and Meta-analysis of COVID-19 Treatment Options.Journal of research in pharmacy practice · 2026Review
- Pyroptosis in Respiratory Virus Infections: A Narrative Review of Mechanisms, Pathophysiology, and Potential Therapeutic Interventions.Microorganisms · 2025Review
- ASIA Syndrome: State-of-the-Art and Future Perspectives.Vaccines · 2024Review
- Expression and characterization of recombinant IL-1Ra in Aspergillus oryzae as a system.BMC biotechnology · 2023Article
- Cancer and COVID-19: unravelling the immunological interplay with a review of promising therapies against severe SARS-CoV-2 for cancer patients.Journal of hematology & oncology · 2023Review
- Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients.Thoracic research and practice · 2023Article
- Anakinra authorized to treat severe coronavirus disease 2019; Sepsis breakthrough or time to reflect?Frontiers in microbiology · 2023Article
- Tocilizumab versus anakinra in COVID-19: results from propensity score matching.Frontiers in immunology · 2023Article
- Anti-TNFα Drugs and Interleukin Inhibitors: Epidemiological and Pharmacovigilance Investigation in COVID-19 Positive Patients.Journal of personalized medicine · 2022Article
- Anti-MDA5 Amyopathic Dermatomyositis-A Diagnostic and Therapeutic Challenge.Life (Basel, Switzerland) · 2022Article
- Comparative Study of Cytokine Storm Treatment in Patients with COVID-19 Pneumonia Using Immunomodulators.Journal of clinical medicine · 2022Article
- Pyroptosis and Its Role in SARS-CoV-2 Infection.Cells · 2022Review
- Diabetes-Modifying Antirheumatic Drugs: The Roles of DMARDs as Glucose-Lowering Agents.Medicina (Kaunas, Lithuania) · 2022Review
- Immune Signature of COVID-19: In-Depth Reasons and Consequences of the Cytokine Storm.International journal of molecular sciences · 2022Review
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSevere COVID-19 cases have a detrimental hyper-inflammatory host response and different cytokine-blocking biologic agents were explored to improve outcomes. Anakinra blocks the activity of both IL-1α and IL‑1β and is approved for different autoinflammatory disorders, but it is used off-label for conditions characterized by an excess of cytokine production. Several studies on anakinra in COVID-19 patients reported positive effects. We performed a meta-analysis of all published evidence on the use of anakinra in COVID19 to investigate its effect on survival and need for mechanical ventilation.
methodsWe searched for any study performed on adult patients with acute hypoxemic failure related to 2019-nCoV infection, receiving anakinra versus any comparator. Primary endpoint was mortality at the longest available follow-up. Adverse effects, need for mechanical ventilation and discharge at home with no limitations were also analysed.
resultsFour observational studies involving 184 patients were included. Overall mortality of patients treated with anakinra was significantly lower than mortality in the control group (95% CI 0.14-0.48, p<0.0001). Moreover, patients treated with anakinra had a significantly lower risk of need for mechanical ventilation than controls (95% CI 0.250.74, p=0.002). No difference in adverse events and discharge at home with no limitations was observed. The Trial Sequential Analysis z-cumulative line reached the monitoring boundary for benefit and the required sample size.
conclusionsAdministration of anakinra in COVID-19 patients was safe and might be associated with reductions in both mortality and need for mechanical ventilation. Randomized clinical trials are warranted to confirm these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.