Baricitinib against severe COVID-19: effectiveness and safety in hospitalised pretreated patients

Eur J Hosp Pharm. 2022 Mar;29(e1):e41-e45. doi: 10.1136/ejhpharm-2021-002741. Epub 2021 Jul 28.

Abstract

Objectives: To analyse the effectiveness and safety of baricitinib for severe COVID-19 in cytokine storm syndrome based on its potential role as an anti-inflammatory immunomodulator and inhibitor of viral endocytosis.

Methods: This was an observational retrospective study of hospitalised patients treated with baricitinib for severe COVID-19. Outcomes were clinical improvement on an ordinal scale of 1-8 on day 1 of baricitinib compared with day 14 (where 8=death and 1=not hospitalised with no limitations of activities), overall survival, time to recovery since baricitinib treatment started (days until hospital discharge) and laboratory parameters related to COVID-19 poor prognosis. Adverse events related to baricitinib during the admission period were also reported.

Results: Forty-three patients (70% men, mean age 70 years (IQR 54-79)) treated with baricitinib daily for 6 days (IQR 5-7) were included. Thirty-six patients were treated with corticosteroids (84%). Clinical improvement was 3 points (IQR 1-4) in patients on an ordinal scale of 4-6, overall survival was 100% at day 30 and day 60 with a mean time to recovery of 12 days (IQR 9-25) from start of baricitinib treatment. No adverse events of interest were found and all poor prognosis risk factors improved at day 14: interleukin-6, C-reactive protein, ferritin, lymphocytes, platelets and D-dimers.

Conclusions: Patients treated with baricitinib for severe COVID-19 showed improvements in clinical and analytical values without relevant adverse events and 100% overall survival. Clinical randomised trials are needed to confirm the clinical benefit of baricitinib.

Keywords: COVID-19; critical care; education; evidence-based medicine; pharmacy; pulmonary medicine; virology.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Azetidines
  • COVID-19 Drug Treatment*
  • Female
  • Humans
  • Male
  • Purines
  • Pyrazoles
  • Retrospective Studies
  • SARS-CoV-2
  • Sulfonamides

Substances

  • Azetidines
  • Purines
  • Pyrazoles
  • Sulfonamides
  • baricitinib