KOMPAS.com – Patients with severe COVID-19 who are hospitalized, who receive the rheumatoid arthritis drug baricitinib in combination with other standards of care, may be less likely to die.
According to a study published in The Lancet Respiratory Medicine, Covid-19 patients died of severe disease less frequently, after their standard of care was combined with rheumatoid arthritis drugs.
The study’s lead investigators were E. Wesley Ely, MD, MPH, Grant Liddle Professor of Medicine at Vanderbilt University Medical Center, and Vince Marconi, MD, of Emory University.
Reported from Medical Xpress, Thursday (2/9/2021), this study involved 1,525 Covid-19 patients with supplemental oxygen, who were treated in 101 hospitals in 12 countries, namely Asia, Europe, North America and South America.
Ely and Marconi did not receive financial compensation for their work in the study, which was funded by Eli Lilly and Company, the company that makes baricitinib rheumatoid arthritis, a drug known for its anti-inflammatory properties.
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In the COV-BARRIER trial, to demonstrate that the drug can reduce the risk of death of Covid-19 patients, recipients were randomly assigned to receive the rheumatoid arthritis drug baricitinib versus a placebo, which is given once daily for up to 14 days in addition to standard care, which includes the drug dexamethasone. and remdesivir.
The COV-BARRIER investigation found that the rheumatoid arthritis drug baricitinib reduced 28-day and 60-day mortality by 5 percent compared with placebo.
“Patients hospitalized with SARS-CoV-2 infection often experience an intense hyperinflammatory state that can lead to multiple organ dysfunction, including acute respiratory distress syndrome, septic shock, and death,” said Ely.
Ely added that although treatment with remdesivir, dexamethasone and tocilizumab, could reduce mortality among hospitalized patients, this standard of treatment remains an important unmet need.
“It is becoming increasingly clear that treatment with baricitinib can help prevent death in some of the most critically ill Covid-19 patients, and that this class of drugs is an important treatment advance for this vulnerable group of patients in this evolving pandemic,” said Ely.
Ely added that the drug baricitinib is an inhibitor of Janus kinases (JAK) 1 and 2, which calm the immune system. In combination with existing treatment standards, it can help reduce the risk of death of Covid-19 patients.
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“A massive computer analysis was carried out early in the pandemic, trying to figure out what drug would be best to reuse for the anti-viral effect of Covid-19,” said Ely.
Drugs with anti-inflammatory or anti-inflammatory effects are also important for sick and hospitalized patients. As for the mode of action of these drugs, JAK inhibitors selectively suppress signals through JAK receptors, blocking the transduction pathways that lead to inflammation.
“Drugs such as baricitinib stop some of the inflammatory cascade pathways to contain the inflammation normally initiated by Covid-19,” explains Ely.
Ely further explained that the COV-BARRIER data showed that the sicker patients were at the time of enrollment, the greater the reduction in mortality.
Data from the COV-BARRIER adjunct, which included patients hospitalized with Covid-19 on mechanical ventilation and ECMO (extracorporeal membrane oxygenation) at admission, showed a greater improvement in survival in the group given the rheumatoid arthritis drug baricitinib.
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However, one surprising finding in the Lancet study was that although the drug reduced the mortality of Covid-19 patients, some patients still experienced progress in the severity of their illness.
“When Covid attacks your body, we don’t find that this drug stops the progress of the disease process completely. If you are already sick, you will continue to get a little sicker,” said Ely.
However, adding the rheumatoid arthritis drug baricitinib to the standard Covid-19 treatment could keep you from jumping over the cliff to death.
The drug baricitinib was identified in February 2020 as a potential intervention for the treatment of Covid-19.
The FDA granted an Emergency Use Authorization (EUA) for this drug in November 2020, to be administered in combination with the drug remdesivir, then changed the EUA later to allow baricitinib to be administered with or without remdesivir.
Lilly donated Covid-19 therapy to Direct Relief, which allows the humanitarian organization to provide COVID-19 therapy at no cost to low- and middle-income countries most affected by the pandemic.
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