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Abstract: FR-PO057

Ravulizumab for COVID-19 Kidney Injury

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Memon, Aliza Anwar, Saint Louis University, Saint Louis, Missouri, United States
  • Ahmed, Hasban, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Siedlecki, Andrew M., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background

The evidence suggests that the primary events in AKI occur on the luminal surface of the endothelial cells in the microvasculature of kidney. These findings can be explained by the activation of the complement resulting in endothelial injury. Ravulizumab inhibits the cleavage of C5 into C5a and C5b thus preventing endothelial dysfunction. In this study, we report the use of ravulizumab to treat AKI in the setting of COVID-19 infection with focus on a primary follow-up period of 30 days.

Methods

Patients were randomized in a placebo-controlled fashion. One group received placebo and standard care (SOC) while the second group received SOC and ravulizumab. Outcomes were rigorously assessed for 30 days after enrollment.

Results

13 (11.4% of screened) patients identified to have COVID-19 infection were enrolled in the study. Six patients were randomized to receive ravulizumab in addition to standard of care (SOC+R) and seven patients were randomized to SOC.Three patients randomized to the SOC group died after enrollment. Mean number of hospital free days after enrollment was 290±47 (SOC+R) vs 164±144 (SOC) respectively. Free C5 levels increased over 30 days following ravulizumab infusion and corresponded with decreasing ravulizumab blood levels over the same time interval (p=0.001). During this same time period there was a decreased number of anuric days observed in the SOC+R compared to SOC (p=0.009). There was a reduced frequency of dialysis events in the SOC+R for ten days after enrollment (p=0.001).

Conclusion

Due to the recurrent impact of COVID-19 infection throughout the world, targeted therapies for concomitant kidney injury merit future investigations to reduce incidence of AKI and potentially reduce future prevalence of CKD.

Funding

  • Commercial Support