Cited by 112COVID-19 Clinical Research StudiesRespiratory Support and MechanismsSARS-CoV-2 and COVID-19 Research

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Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study

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Rodriguez-Garcia, Jose Luis, Sanchez-Nievas, Gines, Arevalo-Serrano, Juan, Garcia-Gomez, Cristina, Jimenez-Vizuete, Jose Maria, Martinez-Alfaro, Elisa·2021·Rheumatology

DOI 10.1093/rheumatology/keaa587PMC PMC7665718

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Abstract

Objectives: The Janus kinase (JAK) inhibitor baricitinib may block viral entry into pneumocytes and prevent cytokine storm in patients with SARS-CoV-2 pneumonia. We aimed to assess whether baricitinib improved pulmonary function in patients treated with high-dose corticosteroids for moderate to severe SARS-CoV-2 pneumonia. Methods: This observational study enrolled patients with moderate to severe SARS-CoV-2 pneumonia [arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2) <200 mmHg] who received lopinavir/ritonavir and HCQ plus either corticosteroids (CS group, n = 50) or corticosteroids and baricitinib (BCT-CS group, n = 62). The primary end point was the change in oxygen saturation as measured by pulse oximetry (SpO2)/FiO2 from hospitalization to discharge. Secondary end points included the proportion of patients requiring supplemental oxygen at discharge and 1 month later. Statistics were adjusted by the inverse propensity score weighting (IPSW). Results: A greater improvement in SpO2/FiO2 from hospitalization to discharge was observed in the BCT-CS vs CS group (mean differences adjusted for IPSW, 49; 95% CI: 22, 77; P < 0.001). A higher proportion of patients required supplemental oxygen both at discharge (62.0% vs 25.8%; reduction of the risk by 82%, OR adjusted for IPSW, 0.18; 95% CI: 0.08, 0.43; P < 0.001) and 1 month later (28.0% vs 12.9%, reduction of the risk by 69%, OR adjusted for IPSW, 0.31; 95% CI: 0.11, 0.86; P = 0.024) in the CS vs BCT-CS group. Conclusions: . In patients with moderate to severe SARS-CoV-2 pneumonia a combination of baricitinib with corticosteroids was associated with greater improvement in pulmonary function when compared with corticosteroids alone. Trial registration: European Network of Centres for Pharmacoepidemiology and Pharmacovigilance, ENCEPP (EUPAS34966, http://www.encepp.eu/encepp/viewResource.htm? id = 34967)

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Authors: Rodriguez-Garcia, J. L., Sanchez-Nievas, G., Arevalo-Serrano, J., Garcia-Gomez, C., Jimenez-Vizuete, J. M., & Martinez-Alfaro, E.
Affiliations: Internal Medicine
Rheumatology, General University Hospital of Albacete, Albacete
Internal Medicine, Principe de Asturias University Hospital, Alcala de Henares
Pharmacy
Anaesthesiology
Infectious Diseases, General University Hospital of Albacete, Albacete, Spain
ORCID: Sanchez-Nievas, Gines
Venue: Rheumatology
Publisher: Oxford University Press (OUP)
Published: 2020-10-06
Volume: 60
Issue: 1
Pages: 399-407
ISSN: 1462-0324 (ISSN-L)
1462-0332
DOI: 10.1093/rheumatology/keaa587
PMC: PMC7665718
OpenAlex: W3089416670
Cited by: 112
References: 38
Citations by year: 2026: 1 · 2025: 3 · 2024: 4 · 2023: 15 · 2022: 35 · 2021: 49 · 2020: 5
FWCI: 3.41
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Lara D. Veeken (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Keywords: baricitinib, COVID-19 pneumonia, COVID-19 pandemic, corticosteroids, JAK inhibitors, lung function, oxygen saturation, supplemental oxygen requirement, lopinavir/ritonavir, hydroxychloroquine, combination therapy, cytokine storm, inverse propensity weighting, pharmacoepidemiology, pharmacovigilance
MeSH terms: Interferon beta-1b, Janus Kinase Inhibitors, COVID-19, SARS-CoV-2, COVID-19 Drug Treatment, Aged, Hypoxia, Antiviral Agents, Azetidines, Drug Combinations, Drug Therapy, Combination, Endothelium, Vascular, Enzyme Inhibitors, Female, Fibrin Fibrinogen Degradation Products, Glucocorticoids, Humans, Hydroxychloroquine, Immunologic Factors, Lung, Male, Methylprednisolone, Middle Aged, Oximetry, Oxygen Inhalation Therapy, Prospective Studies, Purines, Pyrazoles, Severity of Illness Index, Sulfonamides, Cohort Studies, Immunoglobulins, Intravenous, Ritonavir, Lopinavir

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Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study

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