Clinical efficacy and safety of interleukin-1 blockade in the treatment of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

Objective This study evaluated the clinical efficacy and safety of interleukin-1 (IL-1) blockade for patients with COVID-19. Methods The PubMed, Web of Science, Ovid Medline, Embase and Cochrane Library databases were searched for relevant articles from their inception to 25 September 2022. Only randomized clinical trials (RCTs) that assessed the clinical efficacy and safety of IL-1 blockade in the treatment of patients with COVID-19 were included. Results This meta-analysis included seven RCTs. No significant difference in the all-cause mortality rate of patients with COVID-19 was observed between the IL-1 blockade and control groups (7.7 vs. 10.5%, odds ratio [OR] = 0.83, 95% confidence interval [CI] 0.57-1.22; I (2) = 18%). However, the study group was at significantly lower risk of requiring mechanical ventilation (MV) compared with the control group (OR = 0.53, 95% CI 0.32-0.86; I (2) = 24%). Finally, the risk of adverse events was similar between the two groups. Conclusions IL-1 blockade does not provide increased survival benefits in hospitalized patients with COVID-19, but it may reduce the need for MV. Furthermore, it is a safe agent for use in the treatment of COVID-19.> KEY MESSAGES This systematic review and meta-analysis of randomized clinical trials (RCTs) evaluated the clinical efficacy and safety of interleukin-1 (IL-1) blockade for patients with COVID-19. Based on the analysis of six RCTs, no significant difference in the all-cause mortality rate of patients with COVID-19 was observed between the IL-1 blockade and control groups. The study group using IL1 was associated with a significantly lower risk of requiring mechanical ventilation compared with the control group. The risk of adverse events was similar between the study and the control groups.

Automated summary

This study evaluated the clinical efficacy and safety of interleukin-1 (IL-1) blockade for patients with COVID-19. The results showed that IL-1 blockade does not provide increased survival benefits in hospitalized patients with COVID-19, but it may reduce the need for mechanical ventilation. Furthermore, IL-1 blockade is a safe agent for use in the treatment of COVID-19.