AUTHOR=Çaǧlayan Şengül , Sönmez Hafize Emine , Otar Yener Gülçin , Baǧlan Esra , Öztürk Kübra , Ulu Kadir , Guliyeva Vafa , Demirkol Demet , Çakan Mustafa , Özdel Semanur , Bukulmez Hulya , Aktay Ayaz Nuray , Sözeri Betül 

TITLE=Anakinra treatment in multisystemic inflammatory syndrome in children (MIS-C) associated with COVID-19

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.942455

DOI=10.3389/fped.2022.942455

ISSN=2296-2360

ABSTRACT=Objective: The study aimed to report the efficacy and safety of anakinra treatment in patients with refractory multisystemic inflammatory syndrome in children (MIS-C).  
Methods: This is a cross-sectional retrospective study consisting of pediatric patients diagnosed with MIS-C who were treated with anakinra.
Results: Among the 378 patients diagnosed with MIS-C, 82 patients (21.6%) who were treated with anakinra were included in the study. The median age of patients was 115 (6-214) months. The median duration of hospitalization was 15 (6-42) days. Sixty patients (73.1%) were admitted to the pediatric intensive care unit. Patients were treated with a median dose of 2.7 mg/kg/day anakinra concomitant with IVIG and steroids. Intravenous anakinra was applied to 12 patients while 70 patients received it subcutaneously. Twenty-eight patients required high dose (4-10 mg/kg/day) anakinra. The median day of anakinra initiation was 2 (1-14) days and the median duration of anakinra use was 7 (1-41) days.  No injection site reactions were observed while elevated transaminase levels were detected in 13 patients. Seventy-three patients (89.1%) were discharged without any sequela or morbidity.  Seven patients (1.8%) died. Abnormal echocardiographic findings continued in two patients (2.4%) (coronary artery dilatation in one, low ejection fraction in one) at discharge and became normal on the 2nd month.
Conclusion:  Based on the results of the study, anakinra was associated with clinical improvements and was safe for most patients with refractory MIS-C.