Efficacy and safety of imatinib in patients with COVID-19: a systematic review and meta-analysis.

Objective: To inform treatment decisions in clinical practice, we conducted a meta-analysis to evaluate the efficacy and safety of imatinib in patients with COVID-19.

Methods: A comprehensive systematic search was conducted across multiple electronic databases to identify relevant randomized controlled trials (RCTs) comparing imatinib with placebo in patients with COVID-19. A meta-analysis was performed using Review Manager software version 5.3 and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Results: The analysis included 4 studies with a total of 717 patients. The risk ratio (RR) for 28-day mortality in the imatinib group compared to the placebo group was 0.79 (95% confidence interval. CI 0.51-1.21; p = 0.28). There were no statistically significant differences in the duration of oxygen supplementation (MD = -0.13, 95% CI -2.57-2.31; p = 0.92) or the number of ventilator-free days (MD = 4.71, 95% CI -6.97-16.38; p = 0.43). Imatinib treatment did not significantly reduce the duration of hospital or intensive care unit (ICU) stay. Additionally, there was no significant difference between imatinib and placebo in the risk of any adverse events (AEs) or serious AEs.

Conclusion: Imatinib did not significantly improve clinical outcomes in patients with COVID-19. Future research should consider subgroup analyses based on the biological heterogeneity of COVID-19-associated acute respiratory distress syndrome (ARDS) or the concurrent use of interleukin 6 (IL-6) receptor inhibitors to identify patient populations that may benefit from imatinib treatment.