Conestat alfa with Covid-19 and pneumonia

A study tested whether the medicine conestat alfa can alleviate the course of Covid-19 infection and thus avoid the need for mechanical ventilation.

The course of coronavirus disease-19 (Covid-19) varies greatly, with the virus causing severe inflammatory responses in some people. These responses affect various organs, including the lungs, which can result in the need for mechanical ventilation. In the PROTECT-COVID-19 study, Michael Osthoff and his team from Basel University Hospital together with four other hospitals in Switzerland (Stadtspital Triemli and Kantonsspital St. Gallen) and abroad (Brazil and Mexico) investigated whether the use of the anti-inflammatory conestat alfa has a positive effect on the course of an infection, thereby resulting in that mechanical ventilation is less often necessary.

Conestat alfa blocks a number of the inflammatory systems activated by Covid-19. The study involved Individuals suffering from pneumonia caused by SARS-CoV-2. One group of subjects was administered conestat alfa in additional to standard treatment. The study originally planned for 120 subjects but was terminated prematurely. An interim analysis showed that there were already considerable imbalances between the two groups at the start of the study. For example, the severity of disease was higher on average in the conestat alfa group than in the control group. In addition, no positive treatment effect was evident. Although only 84 people had taken part in the study at this time, it was already anticipated that the planned sample of 120 people was too small to eliminate the imbalances. Furthermore, a new effective treatment option against Covid-19 was introduced at the same time.

While the medicine conestat alfa was well tolerated, the results of the study do not support its use against Covid-19. The sample would have needed to be increased significantly to fully rule out a positive effect.

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