Efficacy of Namilumab and Infliximab in the Treatment of COVID-19 Pneumonia

Severe or fatal COVID-19 disease is often associated with deregulated inflammation. A study, published this week in The Lancet, evaluated the effectiveness of 2 anti-inflammatory drugs in hospitalized patients with COVID-19.

The drugs studied were namilumab, a granulocyte-macrophage colony stimulating factor inhibitor, and infliximab, a tumor necrosis factor inhibitor.

Researchers launched CATALYST, a randomized, multicenter, multi-arm, multi-stage, parallel-group, open-label, adaptive, phase 2, proof-of-concept trial. In the study, they recruited COVID-19 hospital patients aged 16 and older. Patients were admitted to 1 of 9 UK hospitals with COVID-19 pneumonia and C-reactive protein (CRP) concentrations of 40 mg / L or more.

Participants randomly received either usual care, usual care and a single intravenous dose of infliximab (5 mg / kg) or usual care and a single intravenous dose of namilumab (150 mg).

From June 15, 2020 to February 18, 2021, investigators recruited 146 participants, of which 54 received usual care, 57 received namilumab, and 35 received infliximab.

The primary endpoint of the study was improvement in inflammation, measured by CRP concentration over time and analyzed with Bayesian models at multiple levels.

After adjusting for other factors that affect patient outcomes, namilumab reduced CRP concentration by 97% and infliximab reduced CRP concentration by 15%.

In the namilumab group, there were 134 adverse events reported in 55% (n = 30) of patients. In comparison, the usual care group recorded 134 adverse events occurring in 54% (n = 29) of patients.

Among infliximab recipients, there were 102 adverse events in 69% (n = 20) of patients. The corresponding usual care group experienced 112 adverse events in 50% (n = 17) of patients.

Deaths occurred in 11% (n = 6) of patients with namilumab and 19% (n = 10) in the usual care group. 14% (n = 4) of the infliximab group died and 15% (n = 5) died in the usual care group.

The completed CATALYST study showed that only namilumab reduced inflammation as measured by the concentration of CRP. The significant reduction in the 97% concentration of CRP should prompt further investigation of namilumab for treatment against COVID-19.