The current COVID-19 pandemic is a worldwide healthcare crisis. Of concern is the large
number of patients that are/will require mechanical ventilation, and the associated strain
that this will place on healthcare resources. At present, there are no specific therapeutic
interventions directed at COVID-19 infection. However, observational data suggest that there
is a subgroup of patients that demonstrate a hyperinflammatory response in response to
COVID-19 and have a higher requirement for Critical Care and higher mortality.
There is a strong case for the use of the naturally occurring anti-inflammatory cytokine
interleukin-1 receptor antagonist (IL-1Ra) in these patients. Anakinra is a recombinant form
of IL-1Ra that is licensed for clinical use. Success of use of anakinra in COVID-19 trials
will be greatly enhanced by robust scientific evidence and established pharmacokinetics which
inform the most effective dosing regimens. The latter is especially important when, as in the
case of anakinra, drug supplies are limited, the drug has short half-life and clinical ease
of application is critical.