Real-Life Effectiveness and Safety of Baricitinib as Adjunctive to Standard-of-Care Treatment in Hospitalized Patients With Severe Coronavirus Disease 2019.
Open Forum Infect Dis
; 9(1): ofab588, 2022 Jan.
Article
em En
| MEDLINE
| ID: mdl-34988257
ABSTRACT
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%, Pâ =â .002). Mortality rate was lower with the combination in the total cohort (14.7% vs 26.6%, Pâ =â .005), and ICU admission was lower in patients with severe acute respiratory distress syndrome (29.7% vs 44.8%, Pâ =â .03). By multivariable analysis, age (odds ratio [OR]â =â 1.82, 95% confidence interval [CI]â =â 1.36-2.44, per 10-year increase), partial pressure of oxygen/fraction of inspired oxygen ratio (ORâ =â 0.60, 95% CIâ =â .52-0.68, per 10 units increase), and use of high-flow nasal cannula (ORâ =â 0.34; 95% CI, .16-0.74) were associated with the composite outcome, whereas baricitinib use was marginally not associated with the composite outcome (ORâ =â 0.52; 95% CI, .26-1.03). However, baricitinib use was found to be significant after inverse-probability weighted regression (ORâ =â 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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article