Background and importance The rapid emergence of SARS-CoV-2 has led to the development of numerous treatments in a short period of time. The need for clinical expertise is vital for better care and follow-up of the hospitalized patient. Baricitinib and remdesivir are two treatments that can be used in combination and have been studied in some clinical trials.
Aim and objectives The aim of this study was to describe the clinical experience of the baricitinib-remdesivir combination in a tertiary hospital, as well as to analyse the adverse event (AE) profile.
Material and methods Observational, descriptive, restrospective and multidisciplinary study of all patients treated with baricitinib-remdesivir from January 2020 to September 2021. The variables collected from the clinical history and the inpatient module (Farmatools) were: age, sex, comorbidities, days of hospital stay, deaths, compliance with treatment criteria and AEs.
Results From the 50 patients studied with the baricitinib-remdesivir combination, 68% (n=34) were men, with an average age of 66 (range 22–94) years. The median days of hospitalisation was 10 (range 4–142).
80% (n=40) of patients presented comorbidities mainly: cardiovascular problems (61%), obesity (15%), obstructive pulmonary disease (14%) and toxic habits (10%).
The number of deaths was 14 (28%), 71% (n=10) were during the hospital stay.
In terms of satisfying the hospital’s criteria for the initiation of treatment, 32% (n=16) of patients were not candidates.
AEs observed were 22% (n=11) infections, 8% (n=4) cardiotoxicity, 8% (n=4) hepatotoxicity and 4% (n=2) vascular events. Treatment was suspended in 4 episodes, due to a positive Quantiferon test (n=3) and due to a thromboembolic phenomenon (n=1). Of the 16 patients who did not fulfil treatment criteria, 6 presented an AE (37.5%).
Conclusion and relevance 32% of the patients were not candidates for treatment, according to the hospital pharmacotherapeutic protocol. This may lead to an increase in the number of AEs. However, more studies with larger sample sizes are needed to obtain more evidence and consistent data.
Treatment should be promoted and monitored only in patients who meet the inclusion criteria, which would lead to a much more efficient and safer pharmacotherapy.
Conflict of interest No conflict of interest