Table 2.
Summary of findings
| Anakinra compared to placebo or standard care alone on clinical outcomes in SARS-CoV-2 patients | |||||
|---|---|---|---|---|---|
| Outcomes Time frame of absolute effects |
Absolute effects from study(ies) (95% CI) | Relative effect 95% CI | Quality of the evidence (GRADE) | ||
| Placebo or Standard Care Alone | Anakinra | Difference with Anakinra | |||
| 28-day mortality | 232 per 1000 |
223 per 1000 (148 to 336) |
9 Fewer per 1000 (84 Fewer—104 More); 4 studies; 1593 participants | 0.96 (0.64 to 1.45) | ⊕ ⊕ ⊖ ⊖ LOW Due to serious inconsistency, Due to serious imprecision |
| 60-day mortality | 125 per 1000 |
233 per 1000 (102 to 526) |
108 More per 1000 (23 Fewer—401 More); 1 study; 115 participants | 1.86 (0.82 to 4.21) | ⊕ ⊕ ⊖ ⊖ LOW Due to very serious imprecision |
| Mortality at hospital discharge | 331 per 1000 |
404 per 1000 (254 to 635) |
73 More per 1000 (76 Fewer—305 More); 2 studies; 889 participants | 1.22 (0.77 to 1.92) |
⊕ ⊕ ⊕ ⊖ MODERATE Due to serious imprecision |
| Clinical worsening: new need for invasive mechanical ventilation or death (at day 28) | 138 per 1000 |
95 per 1000 (42 to 215) |
43 Fewer per 1000 (95 Fewer—77 More); 2 studies; 709 participants | 0.69 (0.31 to 1.56) | ⊕ ⊕ ⊖ ⊖ LOW Due to serious inconsistency, Due to serious imprecision |
| Clinical worsening: new need for invasive mechanical ventilation or death (at day 28) in patients with suPAR ≥ 6 ng/ml | 127 per 1000 |
62 per 1000 (36 to 105) |
65 Fewer per 1000 (90 Fewer—22 Fewer); 1 study; 594 participants | 0.49 (0.29 to 0.83) |
⊕ ⊕ ⊕ ⊖ MODERATE Due to serious imprecision |
| Clinical improvement: discharged without clinical deterioration (at day 28) | 744 per 1000 |
766 per 1000 (654 to 900) |
22 More per 1000 (89 Fewer—156 More); 3 studies; 823 participants | 1.03 (0.88 to 1.21) | ⊕ ⊕ ⊖ ⊖ LOW Due to serious inconsistency, Due to serious imprecision |
| Serious adverse events | 241 per 1000 |
246 per 1000 (163 to 368) |
5 More per 1000 (77 Fewer—128 More); 3 studies, 823 participants | 1.02 (0.68 to 1.53) | ⊕ ⊕ ⊖ ⊖ LOW Due to serious inconsistency, Due to serious imprecision |
| Adverse events (any grade) | 520 per 1000 |
556 per 1000 (436 to 712) |
36 More per 1000 (83 Fewer—192 More); 2 studies; 229 participants | 1.07 (0.84 to 1.37) | ⊕ ⊕ ⊖ ⊖ LOW Due to serious risk of bias, Due to serious imprecision |
| Adverse events (grades 3–4) | 333 per 1000 |
373 per 1000 (223 to 616) |
40 More per 1000 (110 Fewer—283 More); 1 study; 115 participants | 1.12 (0.67 to 1.85) |
⊕ ⊖ ⊖ ⊖ VERY LOW Due to serious risk of bias, Due to very serious imprecision |