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The janus-kinase inhibitor ruxolitinib in SARS-CoV-2 induced acute respiratory distress syndrome (ARDS).
Neubauer, Andreas; Johow, Johannes; Mack, Elisabeth; Burchert, Andreas; Meyn, Damaris; Kadlubiec, Andrea; Torje, Iuliu; Wulf, Hinnerk; Vogelmeier, Claus F; Hoyer, Joachim; Skevaki, Chrysanthi; Muellenbach, Ralf Michael; Keller, Christian; Schade-Brittinger, Carmen; Rolfes, Caroline; Wiesmann, Thomas.
  • Neubauer A; Klinik für Innere Medizin, Hämatologie, Onkologie, Immunologie, Philipps Universität and UKGM, Marburg, Germany. neubauer@staff.uni-marburg.de.
  • Johow J; Coordinating Center for Clinical Trials, Philipps Universität, Marburg, Germany.
  • Mack E; Klinik für Innere Medizin, Hämatologie, Onkologie, Immunologie, Philipps Universität and UKGM, Marburg, Germany.
  • Burchert A; Klinik für Innere Medizin, Hämatologie, Onkologie, Immunologie, Philipps Universität and UKGM, Marburg, Germany.
  • Meyn D; Apotheke, Klinikum Kassel, Kassel, Germany.
  • Kadlubiec A; Klinik für Innere Medizin, Hämatologie, Onkologie, Immunologie, Philipps Universität and UKGM, Marburg, Germany.
  • Torje I; Coordinating Center for Clinical Trials, Philipps Universität, Marburg, Germany.
  • Wulf H; Klinik für Anästhesiologie und Intensivmedizin, Klinikum Kassel, Kassel, Germany.
  • Vogelmeier CF; Klinik für Anästhesiologie und Intensivmedizin, Philipps Universität and UKGM, Marburg, Germany.
  • Hoyer J; Klinik für Innere Medizin, Schwerpunkt Pneumologie, Intensiv- und Schlafmedizin, Philipps Universität and UKGM, Member of the German Center for Lung Research (DZL), Marburg, Germany.
  • Skevaki C; Klinik für Innere Medizin, Nephrologie, Philipps Universität and UKGM, Marburg, Germany.
  • Muellenbach RM; Institut für Labormedizin, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps Universität Marburg, German Center for Lung Research (DZL), Marburg, Germany.
  • Keller C; Klinik für Anästhesiologie und Intensivmedizin, Klinikum Kassel, Kassel, Germany.
  • Schade-Brittinger C; Institut für Virologie, Philipps Universität and UKGM, Marburg, Germany.
  • Rolfes C; Coordinating Center for Clinical Trials, Philipps Universität, Marburg, Germany.
  • Wiesmann T; Klinik für Anästhesiologie und Intensivmedizin, Klinikum Kassel, Kassel, Germany.
Leukemia ; 35(10): 2917-2923, 2021 10.
Article in English | MEDLINE | ID: covidwho-1356548
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 (coronavirus disease 2019), which is associated with high morbidity and mortality, especially in elder patients. Acute respiratory distress syndrome (ARDS) is a life-threatening complication of COVID-19 and has been linked with severe hyperinflammation. Dexamethasone has emerged as standard of care for COVID-19 associated respiratory failure. In a non-randomized prospective phase II multi-center study, we asked whether targeted inhibition of Janus kinase-mediated cytokine signaling using ruxolitinib is feasible and efficacious in SARS-CoV-2- induced ARDS with hyperinflammation. Sixteen SARS-CoV-2 infected patients requiring invasive mechanical ventilation for ARDS were treated with ruxolitinib in addition to standard treatment. Ruxolitinib treatment was well tolerated and 13 patients survived at least the first 28 days on treatment, which was the primary endpoint of the trial. Immediate start of ruxolitinib after deterioration was associated with improved outcome, as was a lymphocyte-to-neutrophils ratio above 0.07. Together, treatment with the janus-kinase inhibitor ruxolitinib is feasible and might be efficacious in COVID-19 induced ARDS patients requiring invasive mechanical ventilation. The trial has been registered under EudraCT-No. 2020-001732-10 and NCT04359290.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pyrazoles / Respiratory Distress Syndrome / Janus Kinases / Janus Kinase Inhibitors / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Leukemia Journal subject: Hematology / Neoplasms Year: 2021 Document Type: Article Affiliation country: S41375-021-01374-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pyrazoles / Respiratory Distress Syndrome / Janus Kinases / Janus Kinase Inhibitors / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Leukemia Journal subject: Hematology / Neoplasms Year: 2021 Document Type: Article Affiliation country: S41375-021-01374-3