TY - JOUR
TI - Real-Life Effectiveness and Safety of Baricitinib as Adjunctive to
Standard-of-Care Treatment in Hospitalized Patients With Severe
Coronavirus Disease 2019
AU - Tziolos, Nikolaos
AU - Karofylakis, Emmanouil
AU - Grigoropoulos, Ioannis
AU - and Kazakou, Pinelopi
AU - Koullias, Emmanouil
AU - Savva, Athina and
AU - Kranidioti, Hariklia
AU - Pelekanou, Aimilia
AU - Boulouta, Anna and
AU - Pirounaki, Maria
AU - Tsiodras, Sotirios
AU - Georgiopoulos, Georgios and
AU - Boumpas, Dimitrios T.
AU - Kavatha, Dimitra
AU - Thomas, Konstantinos and
AU - Vassilopoulos, Dimitrios
AU - Antoniadou, Anastasia
JO - Open Forum Infectious Diseases
PY - 2022
VL - 9
TODO - 1
SP - null
PB - OXFORD UNIV PRESS INC
SN - 2328-8957
TODO - 10.1093/ofid/ofab588
TODO - baricitinib; COVID-19; dexamethasone; ICU admission; respiratory failure
TODO - Background. Therapeutic options for hospitalized patients with severe
coronavirus disease 2019 (sCOVID-19) are limited. Preliminary data have
shown promising results with baricitinib, but real-life experience is
lacking. We assessed the safety and effectiveness of add-on baricitinib
to standard-of-care (SOC) including dexamethasone in hospitalized
patients with sCOVID-19.
Methods. This study is a 2-center, observational, retrospective cohort
study of patients with sCOVID-19, comparing outcomes and serious events
between patients treated with SOC versus those treated with SOC and
baricitinib combination.
Results. We included 369 patients with sCOVID-19 (males 66.1%; mean age
65.2 years; median symptom duration 6 days). The SOC was administered in
47.7% and combination in 52.3%. Patients treated with the combination
reached the composite outcome (intensive care unit [ICU] admission or
death) less frequently compared with SOC (22.3% vs 36.9%, P = .002).
Mortality rate was lower with the combination in the total cohort
(14.7% vs 26.6%, P = .005), and ICU admission was lower in patients
with severe acute respiratory distress syndrome (29.7% vs 44.8%, P =
.03). By multivariable analysis, age (odds ratio [OR] = 1.82, 95%
confidence interval [CI] = 1.36-2.44, per 10-year increase), partial
pressure of oxygen/fraction of inspired oxygen ratio (OR = 0.60, 95% CI
= .52-0.68, per 10 units increase), and use of high-flow nasal cannula
(OR = 0.34; 95% CI, .16-0.74) were associated with the composite
outcome, whereas baricitinib use was marginally not associated with the
composite outcome (OR = 0.52; 95% CI, .26-1.03). However, baricitinib
use was found to be significant after inverse-probability weighted
regression (OR = 0.93; 95% CI, .87-0.99). No difference in serious
events was noted between treatment groups.
Conclusions. In real-life settings, addition of baricitinib to SOC in
patients hospitalized with sCOVID-19 is associated with decreased
mortality without concerning safety signals.
ER -