Anakinra has little to no effect on MIS-C, study finds
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DENVER — The interleukin-1 inhibitor anakinra has little to no effect on moderate to severe multisystem inflammatory syndrome in children, according to researchers.
Esra Akkoyun, MD, a pediatric infectious diseases fellow at the University of Texas Southwestern Medical Center, and colleagues reported their findings at the Pediatric Academic Societies Meeting.
Multisystem inflammatory syndrome in children (MIS-C) is a serious illness linked to SARS-CoV-2 infection.
“Given variability in therapies between centers, optimal regimens of immunomodulatory agents for MIS-C are unknown,” Akkoyun said. “Our hypothesis is use of anakinra in moderate to severe patients is associated with improved outcomes.”
Akkoyun and colleagues evaluated 138 patients aged younger than 21 years who were admitted between May 2020 and May 2021 with a diagnosis of MIS-C, including 109 who were diagnosed with moderate or severe MIS-C. Over a third of the patients (60) had a comorbid condition — asthma in 19 patients, obesity in 18 patients, and other conditions including anemia, hydronephrosis, ADHD and autism in 38 patients.
Of the 138 children with MIS-C, 79% were classified as having a moderate or severe illness. A higher proportion of participants assigned to receive anakinra had severe MIS-C vs. those who did not receive anakinra [49 (86%) vs. 26 (50%), P = < .01].
The researchers found no differences between the groups in fever resolution, reduction in C-reactive protein, or in vasoactive-inotropic score on days following therapy initiation. Length of hospital stay, but not ICU stay, was longer in the anakinra group.
Akkoyun did note, however, that the results did not imply causation, noting that the data came from a single-center observational study early in the pandemic and before the development of variants and introduction of mass vaccination.
“More studies are needed to evaluate the effectiveness of therapies for MIS-C,” Akkoyun said.
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Akkoyun E, et al. Anakinra use in moderate to severe multisystem inflammatory syndrome in children. Presented at: Pediatric Academic Societies Meeting; April 22-25, 2022; Denver.
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