{"id":43983,"date":"2020-12-09T07:28:42","date_gmt":"2020-12-09T07:28:42","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=43983"},"modified":"2026-04-04T23:23:15","modified_gmt":"2026-04-04T23:23:15","slug":"jak-inhibitor-baricitinib-in-moderate-severe-covid-19","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/43983","title":{"rendered":"JAK inhibitor baricitinib in moderate\/severe COVID-19\u00a0"},"content":{"rendered":"
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Simon Collins, HIV i-Base<\/span><\/b><\/p>\n<\/div>\n

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Several small studies have recently reported on using the anti-inflammatory drug baricitinib as a treatment for COVID-19 and larger studies are already underway. <\/span><\/b><\/p>\n<\/div>\n

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<\/strong>The reports below are important for suggesting earlier evidence of potential benefit.<\/span><\/b><\/p>\n<\/div>\n

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The largest of these included 113 patients at the Hospital of Prato in Italy and a control group of 78 matched for baseline characteristics including presenting symptoms and comorbidities.<\/span><\/p>\n<\/div>\n

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Overall, baricitinib was associated with fewer deaths (0 vs 5) and fewer admissions to ICU (1 vs 14).<\/span><\/p>\n<\/div>\n

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A small open-label VA study in Atlanta used single-dose <\/b>baricitinib (2 to 4 mg) to treat 15 participants hospitalised with COVID-19 for its anti-inflammatory and potential off-target antiviral activity.<\/span><\/p>\n<\/div>\n

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Participants needed to have pneumonia requiring oxygen support, moderate disease involving other organs or elevated\/rising inflammatory markers.<\/span><\/p>\n<\/div>\n

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Baseline inflammatory markers (including CRP, IL-6, and ESR) were elevated for all patients.<\/span><\/p>\n<\/div>\n

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Baricitinib was associated with rapidly normalised temperature, reduced inflammation markers in 13\/15 (86%) and clinical symptoms (need for supplementary oxygen) in 12\/15 (80%) of participants. Three participants died.<\/p>\n<\/div>\n

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comment<\/span><\/h3>\n<\/div>\n
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A 10-day course of remdesivir is expected to cost $2,340 in the US, while the cost of a baricitinib course is expected to be less than $500.<\/span><\/strong><\/p>\n<\/div>\n

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Although standard limitations include that this small cohort was not randomised and without a control arm cannot show a causal link, many larger studies are already ongoing.<\/strong><\/p>\n<\/div>\n

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These include at least a dozen smaller phase 2\/3 studies and several larger phase 3\/4 studies are already underway (n >1000 to 1500), including ACTT-2 and the UK TACTIC study. [3, 4, 5]<\/span><\/strong><\/p>\n<\/div>\n

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On 19 November 2020, the US FDA issued an emergency us authorisation for baricitinib in combination with remdesivir. [7] <\/span><\/strong><\/p>\n<\/div>\n

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This was based on baricitinib reducing recovery time compared to placebo, when used with remdesivir in the randomised, double-blind, placebo controlled ACTT-2 study. <\/span><\/strong><\/p>\n<\/div>\n

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References<\/span><\/p>\n<\/div>\n

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  1. Cantini et al. Retrospective, multicenter study on the impact of baricitinib in COVID-19 moderate pneumonia. Journal of Infection. (24 June 2020).
    \n<\/span>https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7313480<\/a><\/li>\n
  2. Titanji BK et al. Use of baricitinib in patients with moderate and severe COVID-19. Clinical Infectious Diseases, ciaa879,\u00a0DOI: 10.1093\/cid\/ciaa879. (29 June 2020).
    \n    https:\/\/academic.oup.com\/cid\/article\/doi\/10.1093\/cid\/ciaa879\/5864596<\/a><\/li>\n
  3. Stebbing J et al. Mechanism of baricitinib supports artificial intelligence\u2010predicted testing in COVID \u201019 patients. Embo Mol Med (2020), e12697. DOI: 10.15252\/emmm.202012697. (24 June 2020).
    \n    https:\/\/www.embopress.org\/doi\/full\/10.15252\/emmm.202012697<\/a><\/li>\n
  4. ClinicalTrials.gov. Adaptive COVID-19 Treatment Trial 2 (ACTT-2).
    \n    https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04401579<\/a><\/li>\n
  5. ClinicalTrials.gov. Efficacy and Safety of Novel Treatment Options for Adults With COVID-19 Pneumonia (CCAP).
    \n    https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04345289<\/a><\/li>\n
  6. ClinicalTrials.gov. Multi-arm therapeutic study in pre-ICU patients admitted with COVID-19 – repurposed drugs (TACTIC-R) (TACTIC-R).
    \n    https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04390464<\/a><\/li>\n
  7. US FDA. Coronavirus (COVID-19) Update: FDA authorizes drug combination for treatment of COVID-19. (19 November 2020).
    \n    https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-authorizes-drug-combination-treatment-covid-19<\/a><\/li>\n<\/ol>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base Several small studies have recently reported on using the anti-inflammatory drug baricitinib as a treatment for COVID-19 and larger studies are already underway. The reports below are important for suggesting earlier evidence of potential benefit. The …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[283,278],"tags":[],"class_list":["post-43983","post","type-post","status-publish","format-standard","hentry","category-covid-19-investigational-drugs","category-covid-19"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43983","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=43983"}],"version-history":[{"count":3,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43983\/revisions"}],"predecessor-version":[{"id":53649,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43983\/revisions\/53649"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=43983"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=43983"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=43983"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}