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Randomized Controlled Trial
. 2024 Sep;89(3):106217.
doi: 10.1016/j.jinf.2024.106217. Epub 2024 Jul 3.

Short- and long-term effects of imatinib in hospitalized COVID-19 patients: A randomized trial

Alex L E Halme  1 , Sanna Laakkonen  2 , Jarno Rutanen  3 , Olli P O Nevalainen  4 , Marjatta Sinisalo  5 , Saana Horstia  6 , Jussi M J Mustonen  7 , Negar Pourjamal  8 , Aija Vanhanen  9 ; Solidarity Finland Investigators; Tuomas Rosberg  19 , Andreas Renner  20 , Markus Perola  21 , Erja-Leena Paukkeri  22 , Riitta-Liisa Patovirta  23 , Seppo Parkkila  24 , Juuso Paajanen  25 , Taina Nykänen  26 , Jarkko Mäntylä  27 , Marjukka Myllärniemi  28 , Tiina Mattila  29 , Maarit K Leinonen  30 , Alvar Külmäsu  31 , Pauliina Kuutti  32 , Ilari Kuitunen  33 , Hanna-Riikka Kreivi  34 , Tuomas P Kilpeläinen  35 , Heikki Kauma  36 , Ilkka E J Kalliala  37 , Petrus Järvinen  38 , Riina Hankkio  39 , Taina Hammarén  40 , Thijs Feuth  41 , Hanna Ansakorpi  42 , Riikka Ala-Karvia  43 , Gordon H Guyatt  44 , Kari A O Tikkinen  45
Collaborators, Affiliations
Free article
Randomized Controlled Trial

Short- and long-term effects of imatinib in hospitalized COVID-19 patients: A randomized trial

Alex L E Halme et al. J Infect. 2024 Sep.
Free article

Abstract

Objectives: We studied the short- and long-term effects of imatinib in hospitalized COVID-19 patients.

Methods: Participants were randomized to receive standard of care (SoC) or SoC with imatinib. Imatinib dosage was 400 mg daily until discharge (max 14 days). Primary outcomes were mortality at 30 days and 1 year. Secondary outcomes included recovery, quality of life and long COVID symptoms at 1 year. We also performed a systematic review and meta-analysis of randomized trials studying imatinib for 30-day mortality in hospitalized COVID-19 patients.

Results: We randomized 156 patients (73 in SoC and 83 in imatinib). Among patients on imatinib, 7.2% had died at 30 days and 13.3% at 1 year, and in SoC, 4.1% and 8.2% (adjusted HR 1.35, 95% CI 0.47-3.90). At 1 year, self-reported recovery occurred in 79.0% in imatinib and in 88.5% in SoC (RR 0.91, 0.78-1.06). We found no convincing difference in quality of life or symptoms. Fatigue (24%) and sleep issues (20%) frequently bothered patients at one year. In the meta-analysis, imatinib was associated with a mortality risk ratio of 0.73 (0.32-1.63; low certainty evidence).

Conclusions: The evidence raises doubts regarding benefit of imatinib in reducing mortality, improving recovery and preventing long COVID symptoms in hospitalized COVID-19 patients.

Keywords: COVID-19; Clinical Trials; Imatinib; Immunomodulatory effects; Long COVID patient outcomes; Post-COVID; Post-acute COVID syndrome; Randomized controlled trial; SARS-CoV-2 infection; Tyrosine kinase inhibitors.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Hanna-Riikka Kreivi is a consultant for Pfizer and Roche and received lecture honoraria from Pfizer. Tiina Mattila is an advisory board member for GSK and received lecture honoraria from AstraZeneca, Boehringer-Ingelheim, Chiesi, GSK, and Orion. All other authors declare no competing interests.

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