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Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study.
Rodriguez-Garcia, Jose Luis; Sanchez-Nievas, Gines; Arevalo-Serrano, Juan; Garcia-Gomez, Cristina; Jimenez-Vizuete, Jose Maria; Martinez-Alfaro, Elisa.
  • Rodriguez-Garcia JL; Internal Medicine.
  • Sanchez-Nievas G; Rheumatology, General University Hospital of Albacete, Albacete.
  • Arevalo-Serrano J; Internal Medicine, Principe de Asturias University Hospital, Alcala de Henares.
  • Garcia-Gomez C; Pharmacy.
  • Jimenez-Vizuete JM; Anaesthesiology.
  • Martinez-Alfaro E; Infectious Diseases, General University Hospital of Albacete, Albacete, Spain.
Rheumatology (Oxford) ; 60(1): 399-407, 2021 01 05.
Article in English | MEDLINE | ID: covidwho-1388014
Semantic information from SemMedBD (by NLM)
1. baricitinib AFFECTS Respiration
Subject
baricitinib
Predicate
AFFECTS
Object
Respiration
2. Respiration PROCESS_OF Patients
Subject
Respiration
Predicate
PROCESS_OF
Object
Patients
3. Adrenal Cortex Hormones TREATS Patients
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Patients
4. Adrenal Cortex Hormones TREATS Pneumonia
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Pneumonia
5. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
6. baricitinib AFFECTS Virus Internalization
Subject
baricitinib
Predicate
AFFECTS
Object
Virus Internalization
7. Storm NOS PROCESS_OF Patients
Subject
Storm NOS
Predicate
PROCESS_OF
Object
Patients
8. baricitinib AFFECTS Pulmonary function
Subject
baricitinib
Predicate
AFFECTS
Object
Pulmonary function
9. Pulmonary function PROCESS_OF Patients
Subject
Pulmonary function
Predicate
PROCESS_OF
Object
Patients
10. hydroxychloroquine ADMINISTERED_TO Patients
Subject
hydroxychloroquine
Predicate
ADMINISTERED_TO
Object
Patients
11. lopinavir / Ritonavir ADMINISTERED_TO Patients
Subject
lopinavir / Ritonavir
Predicate
ADMINISTERED_TO
Object
Patients
12. Oximetr MEASURES C0522534
Subject
Oximetr
Predicate
MEASURES
Object
C0522534
13. Inspired fraction of oxygen COEXISTS_WITH Cortical cataract
Subject
Inspired fraction of oxygen
Predicate
COEXISTS_WITH
Object
Cortical cataract
14. Adrenal Cortex Hormones COEXISTS_WITH baricitinib
Subject
Adrenal Cortex Hormones
Predicate
COEXISTS_WITH
Object
baricitinib
15. Adrenal Cortex Hormones compared_with Adrenal Cortex Hormones
Subject
Adrenal Cortex Hormones
Predicate
compared_with
Object
Adrenal Cortex Hormones
16. baricitinib AFFECTS Respiration
Subject
baricitinib
Predicate
AFFECTS
Object
Respiration
17. Respiration PROCESS_OF Patients
Subject
Respiration
Predicate
PROCESS_OF
Object
Patients
18. Adrenal Cortex Hormones TREATS Patients
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Patients
19. Adrenal Cortex Hormones TREATS Pneumonia
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Pneumonia
20. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
21. baricitinib AFFECTS Virus Internalization
Subject
baricitinib
Predicate
AFFECTS
Object
Virus Internalization
22. Storm NOS PROCESS_OF Patients
Subject
Storm NOS
Predicate
PROCESS_OF
Object
Patients
23. baricitinib AFFECTS Pulmonary function
Subject
baricitinib
Predicate
AFFECTS
Object
Pulmonary function
24. Pulmonary function PROCESS_OF Patients
Subject
Pulmonary function
Predicate
PROCESS_OF
Object
Patients
25. hydroxychloroquine ADMINISTERED_TO Patients
Subject
hydroxychloroquine
Predicate
ADMINISTERED_TO
Object
Patients
26. lopinavir / Ritonavir ADMINISTERED_TO Patients
Subject
lopinavir / Ritonavir
Predicate
ADMINISTERED_TO
Object
Patients
27. Oximetry, Pulse MEASURES Saturated
Subject
Oximetry, Pulse
Predicate
MEASURES
Object
Saturated
28. Inspired fraction of oxygen COEXISTS_WITH Cortical cataract
Subject
Inspired fraction of oxygen
Predicate
COEXISTS_WITH
Object
Cortical cataract
29. Adrenal Cortex Hormones COEXISTS_WITH baricitinib
Subject
Adrenal Cortex Hormones
Predicate
COEXISTS_WITH
Object
baricitinib
30. Adrenal Cortex Hormones compared_with Adrenal Cortex Hormones
Subject
Adrenal Cortex Hormones
Predicate
compared_with
Object
Adrenal Cortex Hormones
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).
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen Inhalation Therapy / Purines / Pyrazoles / Sulfonamides / Azetidines / Methylprednisolone / Janus Kinase Inhibitors / COVID-19 / Glucocorticoids / Hypoxia Type of study: Etiology study / Incidence study / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Rheumatology (Oxford) Journal subject: Rheumatology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen Inhalation Therapy / Purines / Pyrazoles / Sulfonamides / Azetidines / Methylprednisolone / Janus Kinase Inhibitors / COVID-19 / Glucocorticoids / Hypoxia Type of study: Etiology study / Incidence study / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Rheumatology (Oxford) Journal subject: Rheumatology Year: 2021 Document Type: Article