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Conestat alfa for COVID-19
2 studies with 121 patients
Hospital Icon Control
Hospital Icon Conestat alfa Serious Outcome Risk
No significant improvements are seen in meta analysis to date.
COVID-19 Conestat alfa studies. Dec 2025. c19early.org
0 0.5 1 1.5+ All studies -14% Mortality -14% Hospitalization 52% RCTs -14% RCT mortality -14% Late -14% Favorsconestat alfa Favorscontrol
Conestat alfa is a recombinant human C1 esterase inhibitor (rhC1-INH), an intravenous anti-inflammatory drug with the potential to inhibit the complement and kallikrein-kinin cascades in severe COVID-19. Recent:
Urwyler.
Oct 27
2023
 Urwyler et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1255292 Recombinant C1 inhibitor in the prevention of severe COVID-19: a randomized, open-label, multi-center phase IIa trial
238% higher mortality (p=0.26), 286% higher ventilation (p=0.26), 141% higher ICU admission (p=0.32), and 117% lower hospital discharge (p=0.12). RCT 84 hospitalized COVID-19 patients showing higher mortality with conestat alfa (recombinant C1 inhibitor), without reaching statistical significance.
Dec 1
2021
 Bernstein et al., NCT04530136 Recombinant Human C1 Esterase Inhibitor (Ruconest®) in the Prevention of Severe SARS-CoV-2 Infection in Hospitalized Patients With COVID-19: a Randomized, Parallel-group, Open-label, Multi-center Pilot Trial in the US
78% lower mortality (p=0.29), 87% lower ventilation (p=0.08), 46% lower progression (p=0.07), and 52% shorter hospitalization (p=0.06). RCT 38 hospitalized COVID-19 patients showing non-significant improvements with conestat alfa. Results of this manufacturer RCT are notably better than the non-manufacturer RCT [Urwyler].