Русский
Interleukin-6 receptor inhibitor levilimab in the treatment of COVID-19 in patients with chronic kidney disease
DOI: https://dx.doi.org/10.18565/nephrology.2023.1.21-29
Frolova N.F., Tomilina N.A., Usatyuk S.S., Dyakova E.N., Sysoeva I.L., Terentyeva N.V., Frolov M.A., Kim I.G.
1) City Clinical Hospital № 52 of the Moscow Healthcare Department, Moscow, Russia; 2) A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; 3) G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, Moscow, Russia
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.
About the Autors
Nadiya F. Frolova – Cand.Sci. (Med.), Deputy Chief Physician for Nephrological Care, CCH № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182; e-mail: nadiya.frolova@yandex.ru. ORCID: https://orcid.org/0000-0003-3234-8266.
Natalia A. Tomilina – 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. Address: Bldg 1, 20 Delegatskaya st., Moscow, 127473; e-mail: natomilina@yandex.ru. ORCID: https://orcid.org/0000-0002-3603-8524
Sergey S. Usatyuk – Head of the Nephrology Department, CCH № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182; e-mail: usatuk-doc@mail.ru. ORCID: https://orcid.org/0000-0002-8742-3860
Ekaterina N. Dyakova – Doctor at the Nephrology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182. e-mail: katerina-diakova@mail.ru.
Irina L. Sysoeva – Doctor at the Nephrology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department.. Address: 3 Pekhotnaya st., Moscow, 123182. e-mail: i.l.sysoeva@mail.ru.
Natalia V,. Terentyeva – Doctor of the Nephrology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department.. Address: 3 Pekhotnaya st., Moscow, 123182. e-mail: natterentyeva14@mail.ru. ORCID: https://orcid.org/0000-0003-0614-8076.
Mikhail A. Frolov – Laboratory Assistant-Registrar, Moscow City Nephrological Center, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3 Pekhotnaya st., Moscow, 123182. e-mail: mikai01@mail.ru.
Irina G. Kim – Cand. Sci. (Med.), Leading Researcher, G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology of Rospotrebnadzor, Address: 10 Admiral Makarov st., Moscow, 125212. Consultant of the Consultative and Nephrological Department, City Clinical Hospital № 52 of the Moscow Healthcare Department, Address: 3 Pekhotnaya st., Moscow, 123182. e-mail: kig21@rambler.ru.
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