Τίτλος:
Real-Life Effectiveness and Safety of Baricitinib as Adjunctive to
Standard-of-Care Treatment in Hospitalized Patients With Severe
Coronavirus Disease 2019
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Tziolos, Nikolaos
Karofylakis, Emmanouil
Grigoropoulos, Ioannis
and Kazakou, Pinelopi
Koullias, Emmanouil
Savva, Athina and
Kranidioti, Hariklia
Pelekanou, Aimilia
Boulouta, Anna and
Pirounaki, Maria
Tsiodras, Sotirios
Georgiopoulos, Georgios and
Boumpas, Dimitrios T.
Kavatha, Dimitra
Thomas, Konstantinos and
Vassilopoulos, Dimitrios
Antoniadou, Anastasia
Περιοδικό:
Open Forum Infectious Diseases
Εκδότης:
OXFORD UNIV PRESS INC
Λέξεις-κλειδιά:
baricitinib; COVID-19; dexamethasone; ICU admission; respiratory failure
DOI:
10.1093/ofid/ofab588
