Use of Presepsin as a Marker for Immunotherapy Administration in Pneumonia

Inclusion Criteria:

1. Age equal to or above 18 years
2. Male or female gender
3. In case of women of reproductive age, willingness to use dual contraceptive method during the study period
4. Written informed consent provided by the patient. For subjects without decision-making capacity, informed consent must be obtained from a legally designated representative following the national legislation in the Member State where the trial is planned
5. Community-acquired pneumonia or hospital-acquired pneumonia
6. qSOFA score equal to 1
7. Serum presepsin > 350 pg/ml

Exclusion Criteria:

1. Age below 18 years
2. Denial of written informed consent
3. Any stage IV malignancy
4. Any do not resuscitate decision
5. Patients with PaO2/FiO2 less than 150 necessitating non-invasive ventilation or mechanical ventilation
6. Hospitalization in Intensive Care Unit
7. Known hypersensitivity to anakinra
8. Oral or IV intake of corticosteroids at a daily dose equal to or greater than 0.4 mg/kg prednisone for a period greater than the last 15 days
9. qSOFA score 0, 2 or 3
10. Any anti-cytokine biological treatment for the last one month
11. Pregnancy or lactation. Women of child-bearing potential will be screened by a urine pregnancy test before inclusion in the study
12. Participation in any other interventional trial