Early increase of soluble urokinase plasminogen activator receptor (suPAR) serum levels is indicative of increased risk of progression of coronavirus disease 2019 (COVID-19) to respiratory failure. The SAVE-MORE double-blind, randomized controlled trial evaluated the efficacy and safety of anakinra, an IL-1α/β inhibitor, in 594 patients with COVID-19 at risk of progressing to respiratory failure as identified by plasma suPAR ≥6 ng ml⁻¹, 85.9% (n = 510) of whom were receiving dexamethasone. At day 28, the adjusted proportional odds of having a worse clinical status (assessed by the 11-point World Health Organization Clinical Progression Scale (WHO-CPS)) with anakinra, as compared to placebo, was 0.36 (95% confidence interval 0.26–0.50). The median WHO-CPS decrease on day 28 from baseline in the placebo and anakinra groups was 3 and 4 points, respectively (odds ratio (OR) = 0.40, P < 0.0001); the respective median decrease of Sequential Organ Failure Assessment (SOFA) score on day 7 from baseline was 0 and 1 points (OR = 0.63, P = 0.004). Twenty-eight-day mortality decreased (hazard ratio = 0.45, P = 0.045), and hospital stay was shorter.

可溶性尿激酶纤溶酶原激活剂受体 (suPAR) 血清水平的早期升高表明 2019 年冠状病毒病 (COVID-19) 进展为呼吸衰竭的风险增加。 SAVE-MORE 双盲、随机对照试验评估了阿那白滞素（一种 IL-1α/β 抑制剂）在 594 名有进展为呼吸衰竭风险（血浆 suPAR ≥6 ng ml 确定）的 COVID-19 患者中的疗效和安全性⁻¹ ，其中 85.9% ( n = 510) 正在接受地塞米松治疗。在第 28 天，与安慰剂相比，阿那白滞素组出现更差临床状态（通过 11 点世界卫生组织临床进展量表 (WHO-CPS) 评估）的调整后比例几率为 0.36（95% 置信区间 0.26– 0.50）。安慰剂组和阿那白滞素组在第 28 天相对于基线的 WHO-CPS 中值下降分别为 3 点和 4 点（比值比 (OR) = 0.40， P < 0.0001）；第 7 天序贯器官衰竭评估 (SOFA) 评分相对于基线的中位下降分别为 0 分和 1 分（OR = 0.63， P = 0.004）。 28 天死亡率下降（风险比 = 0.45， P = 0.045），住院时间缩短。