BARICITINIB IN HOSPITALIZED PATIENTS WITH COVID-19: META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

ABSTRACT

SESSION TITLE Acute COVID-19 and Beyond from Hospital to Homebound SESSION TYPE Original Investigations PRESENTED ON 10/18/2022 0245 pm - 0345 pm PURPOSE: To date, only dexamethasone, tocilizumab, and casirivimab/imdevimab have been shown to reduce mortality in COVID-19 patients. Baricitinib is a selective Janus kinase 1/2 inhibitor with known anti-inflammatory and anti-viral properties. We sought to perform a meta-analysis of RCTs assessing the role of baricitinib in hospitalized patients with COVID-19 disease. METHODS: Electronic databases such as MEDLINE, EMBASE, and Cochrane Central were searched till March 20, 2022, for randomized controlled trials evaluating the efficacy of baricitinib in hospitalized COVID-19 patients. The outcomes assessed were 28-day mortality, progression to respiratory failure needing positive pressure ventilation or death, progression to mechanical ventilation or ECMO, duration of hospitalization and time to discharge. RESULTS: Four studies (with 10,815 patients) were included in the analysis. In total, 5,477 patients received baricitinib, and 5,338 patients received standard care. Pooled analysis showed a significantly decreased risk of 28-day mortality (OR 0.85, 95% CI 0.76-0.96, p=0.006) and progression to invasive mechanical ventilation or ECMO (OR 0.80, 95% CI 0.69-0.94, p=0.005) in the baricitinib arm compared to standard therapy or placebo. In addition, there was a significant reduction in duration of hospitalization (MD -1.43, 95% CI -2.46, -0.40, p=0.007) and time to recovery (MD -0.88, 95% CI -1.34, -0.41, p=0.0002). CONCLUSIONS: Baricitinib improved the patient-centric outcomes of mortality and progression to severe disease i.e., need for invasive mechanical ventilation, in hospitalized patients with COVID-19 disease compared with standard therapy alone. CLINICAL IMPLICATIONS Baricitinib may be used in conjunction with standard of care treatments to improve morbidity and mortality in hospitalized COVID-19 patients. DISCLOSURES No relevant relationships by Gerardo Carino No relevant relationships by ARKADIY FINN No relevant relationships by Amos Lal No relevant relationships by VIJAIRAM SELVARAJ