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Meta-Analysis
. 2023 Dec;55(1):2208872.
doi: 10.1080/07853890.2023.2208872.

Clinical efficacy and safety of interleukin-1 blockade in the treatment of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

Shao-Huan Lan  1 , Chi-Kuei Hsu  2   3 , Shen-Peng Chang  4 , Li-Chin Lu  5 , Chih-Cheng Lai  6   7
Affiliations
Meta-Analysis

Clinical efficacy and safety of interleukin-1 blockade in the treatment of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

Shao-Huan Lan et al. Ann Med. 2023 Dec.

Abstract

Objective: This study evaluated the clinical efficacy and safety of interleukin-1 (IL-1) blockade for patients with COVID-19.

Methods: The PubMed, Web of Science, Ovid Medline, Embase and Cochrane Library databases were searched for relevant articles from their inception to 25 September 2022. Only randomized clinical trials (RCTs) that assessed the clinical efficacy and safety of IL-1 blockade in the treatment of patients with COVID-19 were included.

Results: This meta-analysis included seven RCTs. No significant difference in the all-cause mortality rate of patients with COVID-19 was observed between the IL-1 blockade and control groups (7.7 vs. 10.5%, odds ratio [OR] = 0.83, 95% confidence interval [CI] 0.57-1.22; I2 = 18%). However, the study group was at significantly lower risk of requiring mechanical ventilation (MV) compared with the control group (OR = 0.53, 95% CI 0.32-0.86; I2 = 24%). Finally, the risk of adverse events was similar between the two groups.

Conclusions: IL-1 blockade does not provide increased survival benefits in hospitalized patients with COVID-19, but it may reduce the need for MV. Furthermore, it is a safe agent for use in the treatment of COVID-19.>.

Keywords: Anakinra; COVID-19; SARS-CoV-2; canakinumab; interleukin-1.

Plain language summary

This systematic review and meta-analysis of randomized clinical trials (RCTs) evaluated the clinical efficacy and safety of interleukin-1 (IL-1) blockade for patients with COVID-19.Based on the analysis of six RCTs, no significant difference in the all-cause mortality rate of patients with COVID-19 was observed between the IL-1 blockade and control groups.The study group using IL1 was associated with a significantly lower risk of requiring mechanical ventilation compared with the control group.The risk of adverse events was similar between the study and the control groups.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flow diagram of study selection.
Figure 2.
Figure 2.
Summary of the bias risk in each domain.
Figure 3.
Figure 3.
Forest plot of the all-cause mortality rate between IL-1 blockade and control group.
Figure 4.
Figure 4.
Forest plot of the risk of requiring mechanical ventilation between IL-1 blockade and control group.
Figure 5.
Figure 5.
Forest plot of the risk of adverse event between IL-1 blockade and control group.
See this image and copyright information in PMC

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Grants and funding

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