Eculizumab as an emergency treatment for adult patients with severe COVID-19 in the intensive care unit: A proof-of-concept study.

Acute respiratory distress syndrome C5 inhibitor Complement pathway Coronavirus Cytokines Pneumonia Sepsis

Journal

EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 01 07 2020
revised: 22 09 2020
accepted: 24 09 2020
pubmed: 12 11 2020
medline: 12 11 2020
entrez: 11 11 2020
Statut: ppublish

Résumé

Complement pathway inhibition may provide benefit for severe acute respiratory illnesses caused by viral infections such as COVID-19. We present results from a nonrandomized proof-of-concept study of complement C5 inhibitor eculizumab for treatment of severe COVID-19. All patients ( At day 15, estimated survival was 82.9% (95% CI: 70.4%‒95.3%) with eculizumab and 62.2% (48.1%‒76.4%) without eculizumab (log-rank test, Findings from this proof-of-concept study suggest eculizumab may improve survival and reduce hypoxia in patients with severe COVID-19. Randomized studies evaluating the efficacy and safety of this treatment approach are needed. Programme d'Investissements d'Avenir: ANR-18-RHUS60004.

Sections du résumé

BACKGROUND BACKGROUND
Complement pathway inhibition may provide benefit for severe acute respiratory illnesses caused by viral infections such as COVID-19. We present results from a nonrandomized proof-of-concept study of complement C5 inhibitor eculizumab for treatment of severe COVID-19.
METHODS METHODS
All patients (
FINDINGS RESULTS
At day 15, estimated survival was 82.9% (95% CI: 70.4%‒95.3%) with eculizumab and 62.2% (48.1%‒76.4%) without eculizumab (log-rank test,
INTERPRETATION CONCLUSIONS
Findings from this proof-of-concept study suggest eculizumab may improve survival and reduce hypoxia in patients with severe COVID-19. Randomized studies evaluating the efficacy and safety of this treatment approach are needed.
FUNDING BACKGROUND
Programme d'Investissements d'Avenir: ANR-18-RHUS60004.

Identifiants

DOI: 10.1016/j.eclinm.2020.100590 PMID: 33173853 PMC: PMC7644240
pubmed: 33173853
doi: 10.1016/j.eclinm.2020.100590
pii: S2589-5370(20)30334-5
pmc: PMC7644240
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100590

Informations de copyright

© 2020 The Author(s).

Déclaration de conflit d'intérêts

Djillali Annane: reports non-financial support from Alexion Pharmaceuticals Inc. and grants from Programme d'Investissements d'Avenir during the conduct of the study; other (investigator) from Alexion outside the submitted work. Nicholas Heming: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study; other (investigator) from Alexion outside the submitted work. Lamiae Grimaldi-Bensouda: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study. Véronique Frémeaux-Bacchi: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study; grants and personal fees from Alexion, personal fees from Roche, personal fees from Apellis, and personal fees from Biocryps outside the submitted work. Marie Vigan: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study. Anne-Laure Roux: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study. Armance Marchal: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study. Hugues Michelon: reports non-financial support from Alexion Pharmaceuticals Inc, during the conduct of the study. Martin Rottman: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study. Pierre Moine: reports non-financial support from Alexion Pharmaceuticals Inc. during the conduct of the study; non-financial support and other (investigator) from Alexion outside the submitted work.

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Auteurs

Djillali Annane (D)

FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis), RHU RECORDS (Rapid rEcognition of CORticosteroiD resistant or sensitive Sepsis), Department of Intensive Care, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, 104 Boulevard Raymond Poincaré, Garches 92380, France.

Nicholas Heming (N)

Department of Intensive Care, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.

Lamiae Grimaldi-Bensouda (L)

Clinical Research Unit AP-HP, Paris-Saclay, Hôpital Raymond Poincaré, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, CESP Anti-Infective Evasion and Pharmacoepidemiology Team, F-78180 Montigny-Le-Bretonneux, France.

Véronique Frémeaux-Bacchi (V)

Laboratory of Immunology, Georges-Pompidou European Hospital (APHP), Invasive Bacterial Infection Unit and National Reference Center for Meningococci, Pasteur Institute, Centre de Recherche des Cordeliers, Paris, France.

Marie Vigan (M)

Clinical Research Unit, AP-HP, Paris-Saclay, Hôpital Raymond Poincaré, Garches, France.

Anne-Laure Roux (AL)

Department of Microbiology and Innovative Biomarkers Platform, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.

Armance Marchal (A)

Laboratory of Immunology, Georges-Pompidou European Hospital (APHP), Paris, France.

Hugues Michelon (H)

Pharmacy Department, Hôpital Raymond Poincaré (APHP), University Paris Saclay, Garches, France.

Martin Rottman (M)

Department of Microbiology and Innovative Biomarkers Platform, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.

Pierre Moine (P)

Department of Intensive Care, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.

Classifications MeSH