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Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19.
Respir Investig. 2021 Nov; 59(6):799-803.RI

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib-a Janus kinase inhibitor, remdesivir, and dexamethasone (BRD) are unknown.

METHODS

Patients who received combination therapy with BRD at the Japanese Red Cross Medical Center were enrolled in the study. All patients received baricitinib (≤14 d), remdesivir (≤10 d), and dexamethasone (≤10 d). The efficacy and adverse events were evaluated.

RESULTS

In total, 44 patients with severe COVID-19 were enrolled in this study. The 28-d mortality rate was low at 2.3% (1/44 patients). The need for invasive mechanical ventilation was avoided in most patients (90%, 17/19 patients). Patients who received BRD therapy had a median hospitalization duration of 11 d, time to recovery of 9 d, duration of intensive care unit stay of 6 d, duration of invasive mechanical ventilation of 5 d, and duration of supplemental oxygen therapy of 5 d. Adverse events occurred in 15 patients (34%). Liver dysfunction, thrombosis, iliopsoas hematoma, renal dysfunction, ventilator-associated pneumonia, infective endocarditis, and herpes zoster occurred in 11%, 11%, 2%, 2%, 2%, 2%, and 2% of patients, respectively.

CONCLUSIONS

Combination therapy with BRD was effective in treating severe COVID-19, and the incidence rate of adverse events was low. The results of the present study are encouraging; however, further randomized clinical studies are needed.

Authors+Show Affiliations

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan. Electronic address: izumo_takehiro@med.jrc.or.jp.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34413006

Citation

Izumo, Takehiro, et al. "Clinical Impact of Combination Therapy With Baricitinib, Remdesivir, and Dexamethasone in Patients With Severe COVID-19." Respiratory Investigation, vol. 59, no. 6, 2021, pp. 799-803.
Izumo T, Kuse N, Awano N, et al. Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19. Respir Investig. 2021;59(6):799-803.
Izumo, T., Kuse, N., Awano, N., Tone, M., Sakamoto, K., Takada, K., Muto, Y., Fujimoto, K., Saiki, A., Ito, Y., Matsumoto, H., & Inomata, M. (2021). Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19. Respiratory Investigation, 59(6), 799-803. https://doi.org/10.1016/j.resinv.2021.07.004
Izumo T, et al. Clinical Impact of Combination Therapy With Baricitinib, Remdesivir, and Dexamethasone in Patients With Severe COVID-19. Respir Investig. 2021;59(6):799-803. PubMed PMID: 34413006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19. AU - Izumo,Takehiro, AU - Kuse,Naoyuki, AU - Awano,Nobuyasu, AU - Tone,Mari, AU - Sakamoto,Keita, AU - Takada,Kohei, AU - Muto,Yutaka, AU - Fujimoto,Kazushi, AU - Saiki,Ayae, AU - Ito,Yu, AU - Matsumoto,Haruko, AU - Inomata,Minoru, Y1 - 2021/08/10/ PY - 2021/04/28/received PY - 2021/06/15/revised PY - 2021/07/19/accepted PY - 2021/8/21/pubmed PY - 2021/11/18/medline PY - 2021/8/20/entrez KW - Acute respiratory distress syndrome KW - Adverse event KW - Coronavirus disease 2019 KW - Efficacy KW - Severe acute respiratory syndrome coronavirus 2 SP - 799 EP - 803 JF - Respiratory investigation JO - Respir Investig VL - 59 IS - 6 N2 - BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib-a Janus kinase inhibitor, remdesivir, and dexamethasone (BRD) are unknown. METHODS: Patients who received combination therapy with BRD at the Japanese Red Cross Medical Center were enrolled in the study. All patients received baricitinib (≤14 d), remdesivir (≤10 d), and dexamethasone (≤10 d). The efficacy and adverse events were evaluated. RESULTS: In total, 44 patients with severe COVID-19 were enrolled in this study. The 28-d mortality rate was low at 2.3% (1/44 patients). The need for invasive mechanical ventilation was avoided in most patients (90%, 17/19 patients). Patients who received BRD therapy had a median hospitalization duration of 11 d, time to recovery of 9 d, duration of intensive care unit stay of 6 d, duration of invasive mechanical ventilation of 5 d, and duration of supplemental oxygen therapy of 5 d. Adverse events occurred in 15 patients (34%). Liver dysfunction, thrombosis, iliopsoas hematoma, renal dysfunction, ventilator-associated pneumonia, infective endocarditis, and herpes zoster occurred in 11%, 11%, 2%, 2%, 2%, 2%, and 2% of patients, respectively. CONCLUSIONS: Combination therapy with BRD was effective in treating severe COVID-19, and the incidence rate of adverse events was low. The results of the present study are encouraging; however, further randomized clinical studies are needed. SN - 2212-5353 UR - https://www.unboundmedicine.com/medline/citation/34413006/Clinical_impact_of_combination_therapy_with_baricitinib_remdesivir_and_dexamethasone_in_patients_with_severe_COVID_19_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-5345(21)00125-8 DB - PRIME DP - Unbound Medicine ER -