Medical World News

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March 24, 2022, Updated NIH COVID-19 Treatment Guidelines

Updated NIH COVID-19 Treatment Guidelines include updated results and interpretation from lenzilumab LIVE-AIR study now published in The Lancet Respiratory Medicine. The updated interpretation of LIVE-AIR concludes “Lenzilumab improved ventilator-free survival in participants with hypoxemia who were not receiving MV, with the greatest benefit among those with lower CRP levels”, based on the increased incidence of ventilator-free survival observed in patients with CRP <150 mg/L (90% vs 79%, HR 2.54; 95% CI, 1.46–4.41; P=0.0009). Currently, lenzilumab is not yet authorized or approved but is available via compassionate use in some countries (U.S., ex-U.S.). Guidelines state that while GM-CSF is believed to be a key driver of lung inflammation in COVID-19 pneumonia, operating upstream of other pro-inflammatory cytokines and chemokines, NIH interpretation of clinical data show that lenzilumab is the only GM-CSF inhibitor to demonstrate a benefit in the treatment of COVID-19. Lenzilumab may mitigate inflammation by inhibiting this signaling axis upstream of IL-6 and IL-1 and thus minimizing downstream production of numerous pro-inflammatory mediators involved in the pathogenesis of COVID-19.