Efficacy and safety of Ixekizumab vs. low-dose IL-2 vs. Colchicine vs. standard of care in the treatment of patients hospitalized with moderate-to-critical COVID-19: A pilot randomized clinical trial (STRUCK: Survival Trial Using Cytokine Inhibitors)

ABSTRACT Background: Cases of coronavirus disease 2019 (COVID-19) requiring hospitalization continue to appear in vulnerable populations, highlighting the importance of novel treatments. The hyperinflammatory response underlies the severity of the disease, and targeting this pathway may be useful. Herein, we tested whether immunomodulation focusing on interleukin (IL)-6, IL-17, and IL-2, could improve the clinical outcomes of patients admitted with COVID-19. Methods: This multicenter, open-label, prospective, randomized controlled trial was conducted in Brazil. Sixty hospitalized patients with moderate-to-critical COVID-19 received in addition to standard of care (SOC): IL-17 inhibitor (ixekizumab 80 mg SC/week) 1 dose every 4 weeks; low-dose IL-2 (1.5 million IU per day) for 7 days or until discharge; or indirect IL-6 inhibitor (colchicine) orally (0.5 mg) every 8 hours for 3 days, followed by 4 weeks at 0.5 mg 2x/day; or SOC alone. The primary outcome was accessed in the “per protocol” population as the proportion of patients with clinical improvement, defined as a decrease greater or equal to two points on the World Health Organization’s (WHO) seven-category ordinal scale by day 28. Results: All treatments were safe, and the efficacy outcomes did not differ significantly from those of SOC. Interestingly, in the colchicine group, all participants had an improvement of greater or equal to two points on the WHO seven-category ordinal scale and no deaths or patient deterioration were observed. Conclusions: Ixekizumab, colchicine, and IL-2 were demonstrated to be safe but ineffective for COVID-19 treatment. These results must be interpreted cautiously because of the limited sample size

Supplemental_Material_Study_Sites - Efficacy and Safety of a Biosimilar Versus Branded Enoxaparin in the Prevention of Venous Thromboembolism Following Major Abdominal Surgery: A Randomized, Prospective, Single-Blinded, Multicenter Clinical Trial

<p>Supplemental_Material_Study_Sites for Efficacy and Safety of a Biosimilar Versus Branded Enoxaparin in the Prevention of Venous Thromboembolism Following Major Abdominal Surgery: A Randomized, Prospective, Single-Blinded, Multicenter Clinical Trial by Eduardo Ramacciotti, Ubirajara Ferreira, Agenor José Vasconcelos Costa, Selma Regina O. Raymundo, João Antônio Correa, Salvador Gullo Neto, Alessandro Bersch Osvaldt, Leandro Agati, Valéria Cristina Resende Aguiar, Ronaldo Davila, Tania Benevenuto Caltabiano, Flávia Magalhães Magella, Giuliano Giova Volpiani, Valter Castelli, Roberto Augusto Caffaro, Lucas Zeponi DalAcqua, Wagner Eduardo Matheus, Debora Yuri Sato, Gleison Juliano da Silva Russeff, Daniela Garcia de Souza, Lucas Eduardo Pazetto, Tiago Aparecido Maschio de Lima, Eloá Maria da Silva Colnago, Eliane Yumii Fugii, Juliana Sekeres Mussalem, Vanessa Therumi Assao, Odaly Toffoletto, Debora Garcia Rodrigues, Jorge Barros Afiune, and Gilson Roberto Araujo in Clinical and Applied Thrombosis/Hemostasis</p