Baricitinib in hospitalised patients with COVID-19: a meta-analysis of randomised controlled trials
Open accessAbstract
Background To date, only dexamethasone and tocilizumab have been shown to reduce mortality in patients with COVID-19. Baricitinib is a Janus kinase 1/2 inhibitor with known anti-inflammatory and anti-viral properties. We performed a meta-analysis of RCTs assessing the role of baricitinib in hospitalised patients with COVID-19. Methods Electronic databases such as MEDLINE, EMBASE, and Cochrane Central were searched up until March 31, 2022, for RCTs evaluating the efficacy of baricitinib in hospitalised patients with COVID-19. The outcomes assessed were 28-day mortality, progression to invasive mechanical ventilation (IMV) or ECMO, progression to respiratory failure needing positive pressure ventilation, IMV or death, duration of hospitalisation and time to discharge. The meta-analysis was registered in the PROSPERO database (CRD42022314579). Findings Four studies (with 10,815 patients) were included in the analysis. Pooled analysis using random-effects model showed a statistically significant reduction in 28-day mortality (OR 0.69, 95% CI 0.50-0.94; p=0.04, I 2 =65%) and composite outcome of progression to severe disease needing positive pressure ventilation, IMV or death (OR 0.89, 95% CI 0.80-0.99, p=0.03, I 2 =0%). There was a favorable trend towards reduced progression to IMV or ECMO (OR 0.76, 95% CI 0.58-1.01; p=0.06, I 2 =49%) in the baricitinib arm compared to standard therapy, even though it was not statistically significant. Statistical significance was achieved for all outcomes with fixed-effects model analysis. Interpretation In hospitalised patients with COVID-19, baricitinib was associated with reduced 28-day mortality although there was not a statistically significant reduction in progression to IMV or ECMO. Baricitinib used in conjunction with standard of care treatments is associated with improved mortality in hospitalised patients with COVID-19 disease. Funding None.
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Baricitinib lowers 28-day mortality in hospitalized COVID-19 patients in a significant manner.
“Baricitinib lowers 28-day mortality in hospitalized COVID-19 patients in a significant manner (54).”
From DrugCentral 2023 extends human clinical data and integrates veterinary drugs (2023) · cites this paper as [54]
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- Authors
- Selvaraj, V., Finn, A., Lal, A., Khan, M. S., Dapaah-Afriyie, K., & Carino, G. P.
- Affiliations
- Brown University (US)
- Mayo Clinic (US)
- University of Kentucky (US)
- Rhode Island Hospital (US)
- Corresponding author
- Selvaraj, Vijairam
- ORCID
- Venue
- EClinicalMedicine
- Publisher
- Elsevier BV
- Published
- 2022-07
- Volume
- 49
- Pages
- 101489
- ISSN
- 2589-5370 (ISSN-L)
- PMC
- PMC9163705
- OpenAlex
- W4281673562
- Cited by
- 101
- References
- 33
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 26 · 2023: 32 · 2022: 21
- FWCI
- 3.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- EClinicalMedicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- baricitinib, COVID-19 pandemic, hospitalized patients, 28-day mortality, invasive mechanical ventilation, extracorporeal membrane oxygenation, respiratory failure, JAK inhibitors, disease progression, length of hospital stay
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