Imatinib yields sustained clinical benefit in patients with hypoxemic COVID-19

SAN FRANCISCO — Treatment with imatinib resulted in a sustained clinical benefit after 90 days in hospitalized patients with hypoxemic COVID-19, according to results of the CounterCOVID study.

At the American Thoracic Society International Conference, Job R. Schippers, MD-PhD candidate for pulmonary medicine at Amsterdam University Medical Center, presented long-term clinical outcomes at 90 days after treatment with imatinib.

Imatinib is a tyrosine kinase inhibitor that is currently used as an oncology drug to block an abnormal protein that signals cancer cells, according to an ATS press release.

“Imatinib was considered as a therapeutic option when it became evident that patients with severe COVID-19 had CT scan abnormalities suggestive of pulmonary edema ... as a result of vascular leakage,” Schippers said in the release.

Results of a recent clinical trial demonstrated a benefit of imatinib treatment over 28-day follow-up in patients with hypoxemic COVID-19, with the greatest improvement in critically ill patients, according to the researchers.

Researchers evaluated longer-term clinical outcomes in 385 patients hospitalized with COVID-19. Patients were randomly assigned to imatinib (n = 197) or placebo (n = 188) for 10 days. Long-term outcomes included 90-day mortality, duration of invasive ventilation, ventilator-free days, length of ICU admission, length of hospital admission and ventilatory parameters.

At 90 days, 9.1% of patients who received imatinib and 16.5% of patients who received placebo died (HR = 0.53; 95% CI, 0.29-0.94; P = .03), according to the abstract. This result remained significant after the researchers adjusted for baseline imbalances including sex, obesity, diabetes and heart disease (HR = 0.52; 95% CI, 0.28-0.99; P = .045), according to the abstract.

The median number of ventilator-free days was 84 for patients in the ICU who received imatinib compared with 64 days for those who received placebo (P = .036) and median duration of invasive ventilation was 7 days compared with 12 days, respectively (P = .026), according to the abstract.

Mean length of ICU stay was 9 days in the imatinib group compared with 15 days in the placebo group (P = .098) and mean duration of hospitalization was 7 days compared with 6.5 days, respectively (P = .66).

Patients who were intubated and treated with imatinib had a significantly better longitudinal FiO2 course (P < .0001), the researchers reported in the abstract.

According to the researchers, the clinical benefit observed at 90 days may be explained by the improvement in oxygenation parameters.

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