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Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study
Open accessAbstract
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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“Further support comes from positive anecdotal reports of targeted antagonists against interleukin-1, granulocyte–macrophage colony-stimulating factor, and JAK1 and JAK2 in patients with Covid-19.102-105”
From Cytokine storm (2020) · cites this paper as [105]
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Metadata
- 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
- 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
- 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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