Interleukin-6 receptor inhibitor levilimab in the treatment of COVID-19 in patients with chronic kidney disease

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Аннотация

Background. Chronic kidney disease (CKD) is a risk factor for severe and fatal novel coronavirus infection. The interleukin-6 (IL-6) receptor inhibitor levilimab improves the prognosis of COVID-19 by stopping the hyperimmune response.

Objective. Evaluation of the efficacy and safety of levilimab in the treatment of COVID-19 in patients with chronic kidney disease.

Material and methods. A retrospective analysis of the data of 56 patients with CKD (in the majority - stages 3A–4) with the median serum creatinine level 173 (137; 237) µmol/l, who received levilimab for moderate and severe COVID-19, was carried out. Levilimab was prescribed at a dose of 162 to 648 mg, mainly intravenously on the first day of hospitalization.

Results. During therapy with levilimab, there was a rapid relief of symptoms of hyperinflammation and a decrease in the need for oxygen therapy. There was no deterioration in renal function in any patient. On the contrary, in 75% the creatinine level decreased, median level at the time of discharge was 127 (106; 185) µmol/l, which was accompanied by an increase in the median glomerular filtration rate from 27.5 at admission to 41 ml/min/1.73 m2 at discharge (P<0.0001). In the period from the 4th to the 18th day of hospitalization, 94.6% of patients were discharged with recovery, which was accompanied by an improvement in kidney function in 79% of cases. A lethal outcome was observed in 3 (5.4%) patients who were admitted to the intensive care unit in an extremely serious condition and had severe concomitant pathology. No serious side effects were observed during treatment with levilimab.

Conclusion. In patients with CKD, levilimab has a good safety profile and is quite effective as a pathogenetic therapy for COVID-19, regardless of the degree of renal dysfunction.

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Авторлар туралы

Nadiya Frolova

City Clinical Hospital № 52 of the Moscow Healthcare Department; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Хат алмасуға жауапты Автор.
Email: nadiya.frolova@yandex.ru
ORCID iD: 0000-0003-3234-8266

Cand.Sci. (Med.), Deputy Chief Physician for Nephrological Care, CCH № 52 of the Moscow Healthcare Department

Ресей, Moscow; Moscow

Natalia Tomilina

City Clinical Hospital № 52 of the Moscow Healthcare Department; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: natomilina@yandex.ru
ORCID iD: 0000-0002-3603-8524

Dr.Sci. (Med.), Professor, Head of the Department of Nephrology, Faculty of Additional Professional Education, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Consultant at the Consultative and Nephrological Department, CCH № 52 of the Moscow Healthcare Department

Ресей, Moscow; Moscow

Sergey Usatyuk

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: usatuk-doc@mail.ru
ORCID iD: 0000-0002-8742-3860

Head of the Nephrology Department, CCH № 52 of the Moscow Healthcare Department

Ресей, Moscow

Ekaterina Dyakova

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: katerina-diakova@mail.ru

Doctor at the Nephrology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department

Ресей, Moscow

Irina Sysoeva

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: i.l.sysoeva@mail.ru

Doctor at the Nephrology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department

Ресей, Moscow

Natalia Terentyeva

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: natterentyeva14@mail.ru
ORCID iD: 0000-0003-0614-8076

Doctor of the Nephrology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department

Ресей, Moscow

Mikhail Frolov

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: mikai01@mail.ru

Laboratory Assistant-Registrar, Moscow City Nephrological Center, City Clinical Hospital № 52 of the Moscow Healthcare Department

Ресей, Moscow

Irina Kim

City Clinical Hospital № 52 of the Moscow Healthcare Department; G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor

Email: kig21@rambler.ru

Cand. Sci. (Med.), Leading Researcher, G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology of Rospotrebnadzor, Consultant of the Consultative and Nephrological Department, City Clinical Hospital № 52 of the Moscow Healthcare Department

Ресей, Moscow; Moscow

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