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Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study.
Rheumatology (Oxford). 2021 01 05; 60(1):399-407.R

Abstract

OBJECTIVES

The Janus kinase (JAK) inhibitor baricitinib may block viral entry into pneumocytes and prevent cytokine storm in patients with SARS-CoV-2 pneumonia. We aimed to assess whether baricitinib improved pulmonary function in patients treated with high-dose corticosteroids for moderate to severe SARS-CoV-2 pneumonia.

METHODS

This observational study enrolled patients with moderate to severe SARS-CoV-2 pneumonia [arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2) <200 mmHg] who received lopinavir/ritonavir and HCQ plus either corticosteroids (CS group, n = 50) or corticosteroids and baricitinib (BCT-CS group, n = 62). The primary end point was the change in oxygen saturation as measured by pulse oximetry (SpO2)/FiO2 from hospitalization to discharge. Secondary end points included the proportion of patients requiring supplemental oxygen at discharge and 1 month later. Statistics were adjusted by the inverse propensity score weighting (IPSW).

RESULTS

A greater improvement in SpO2/FiO2 from hospitalization to discharge was observed in the BCT-CS vs CS group (mean differences adjusted for IPSW, 49; 95% CI: 22, 77; P < 0.001). A higher proportion of patients required supplemental oxygen both at discharge (62.0% vs 25.8%; reduction of the risk by 82%, OR adjusted for IPSW, 0.18; 95% CI: 0.08, 0.43; P < 0.001) and 1 month later (28.0% vs 12.9%, reduction of the risk by 69%, OR adjusted for IPSW, 0.31; 95% CI: 0.11, 0.86; P = 0.024) in the CS vs BCT-CS group.

CONCLUSIONS

. In patients with moderate to severe SARS-CoV-2 pneumonia a combination of baricitinib with corticosteroids was associated with greater improvement in pulmonary function when compared with corticosteroids alone.

TRIAL REGISTRATION

European Network of Centres for Pharmacoepidemiology and Pharmacovigilance, ENCEPP (EUPAS34966, http://www.encepp.eu/encepp/viewResource.htm? id = 34967).

Authors+Show Affiliations

Internal Medicine.Rheumatology, General University Hospital of Albacete, Albacete.Internal Medicine, Principe de Asturias University Hospital, Alcala de Henares.Pharmacy.Anaesthesiology.Infectious Diseases, General University Hospital of Albacete, Albacete, Spain.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

33020836

Citation

Rodriguez-Garcia, Jose Luis, et al. "Baricitinib Improves Respiratory Function in Patients Treated With Corticosteroids for SARS-CoV-2 Pneumonia: an Observational Cohort Study." Rheumatology (Oxford, England), vol. 60, no. 1, 2021, pp. 399-407.
Rodriguez-Garcia JL, Sanchez-Nievas G, Arevalo-Serrano J, et al. Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study. Rheumatology (Oxford). 2021;60(1):399-407.
Rodriguez-Garcia, J. L., Sanchez-Nievas, G., Arevalo-Serrano, J., Garcia-Gomez, C., Jimenez-Vizuete, J. M., & Martinez-Alfaro, E. (2021). Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study. Rheumatology (Oxford, England), 60(1), 399-407. https://doi.org/10.1093/rheumatology/keaa587
Rodriguez-Garcia JL, et al. Baricitinib Improves Respiratory Function in Patients Treated With Corticosteroids for SARS-CoV-2 Pneumonia: an Observational Cohort Study. Rheumatology (Oxford). 2021 01 5;60(1):399-407. PubMed PMID: 33020836.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study. AU - Rodriguez-Garcia,Jose Luis, AU - Sanchez-Nievas,Gines, AU - Arevalo-Serrano,Juan, AU - Garcia-Gomez,Cristina, AU - Jimenez-Vizuete,Jose Maria, AU - Martinez-Alfaro,Elisa, PY - 2020/06/13/received PY - 2020/08/12/revised PY - 2020/10/7/pubmed PY - 2021/1/16/medline PY - 2020/10/6/entrez KW - COVID-19 KW - SARS-CoV-2 KW - baricitinib KW - corticosteroids SP - 399 EP - 407 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 60 IS - 1 N2 - OBJECTIVES: The Janus kinase (JAK) inhibitor baricitinib may block viral entry into pneumocytes and prevent cytokine storm in patients with SARS-CoV-2 pneumonia. We aimed to assess whether baricitinib improved pulmonary function in patients treated with high-dose corticosteroids for moderate to severe SARS-CoV-2 pneumonia. METHODS: This observational study enrolled patients with moderate to severe SARS-CoV-2 pneumonia [arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2) <200 mmHg] who received lopinavir/ritonavir and HCQ plus either corticosteroids (CS group, n = 50) or corticosteroids and baricitinib (BCT-CS group, n = 62). The primary end point was the change in oxygen saturation as measured by pulse oximetry (SpO2)/FiO2 from hospitalization to discharge. Secondary end points included the proportion of patients requiring supplemental oxygen at discharge and 1 month later. Statistics were adjusted by the inverse propensity score weighting (IPSW). RESULTS: A greater improvement in SpO2/FiO2 from hospitalization to discharge was observed in the BCT-CS vs CS group (mean differences adjusted for IPSW, 49; 95% CI: 22, 77; P < 0.001). A higher proportion of patients required supplemental oxygen both at discharge (62.0% vs 25.8%; reduction of the risk by 82%, OR adjusted for IPSW, 0.18; 95% CI: 0.08, 0.43; P < 0.001) and 1 month later (28.0% vs 12.9%, reduction of the risk by 69%, OR adjusted for IPSW, 0.31; 95% CI: 0.11, 0.86; P = 0.024) in the CS vs BCT-CS group. CONCLUSIONS: . In patients with moderate to severe SARS-CoV-2 pneumonia a combination of baricitinib with corticosteroids was associated with greater improvement in pulmonary function when compared with corticosteroids alone. TRIAL REGISTRATION: European Network of Centres for Pharmacoepidemiology and Pharmacovigilance, ENCEPP (EUPAS34966, http://www.encepp.eu/encepp/viewResource.htm? id = 34967). SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/33020836/Baricitinib_improves_respiratory_function_in_patients_treated_with_corticosteroids_for_SARS_CoV_2_pneumonia:_an_observational_cohort_study_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/keaa587 DB - PRIME DP - Unbound Medicine ER -