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J Infect Dev Ctries
. 2022 Jan 31;16(1):63-72.
doi: 10.3855/jidc.15126.
Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting
Roberto Ovilla-Martinez 1 , Xochitl Cota-Rangel 1 , Jose De La Peña-Celaya 1 , Mariana Alejandra Alvarado-Zepeda 2 , Alejandro Jiménez Sastré 3 , Humberto Azuara Forcelledo 3 , Bernardino Ordoñez Rodriguez 3 , Juan Pulido Broca 3 , Aaron Molina Jaimes 4 , Alejandro Muñiz-Carvajal 5 , Maria Magdalena Bahena García 6 , Eduardo Cervera Ceballos 7 , Nidia Paulina Zapata Canto 7 , Jorge Oscar García Mendez 7 , Omar Noel García Jímenez 8 , Jesus Alberto Salas Heredia 9 , Javier Solis Soto 9 , Ruben Alberto Villalobos Mendez 10 , Gregorio Ignacio Ibarra 11 , Cindy Ledesma de la Cruz 11 , Nora Araujo Martinez 2 , Jessi Juárez Lara 11 , Cecilio Omar Ceballos Zuñiga 12 , Felipe Vicente Villaseñor Pérez 11 , Jose Carlos Herrera Garcia 13 , Patricia Nuche Salazar 13 , Alfredo Dominguez Paregrina 13 , Bertha Arizpe Bravo 13 , Gabriela Enciso Figueroa 13 , Teresita Trujillo 13 , Adriana Miguel Álvarez 11 , Diego de Jesús García Gallegos 14 , Alejandro Ortiz Arroyo 2 , Claudia Ivette Solorzano Soto 15 , Hiram Javier Jaramillo Ramírez 16 , Ibis De la Cruz Hernández 17 , Sergio De Gante Martínez 18 , Guadalupe Esmeralda Montesinos Gómez 17 , Silvia Martínez Velasco 17 , Roberto García Graullera 19 , Miguel Angel Vázquez López 20 , Victor Itaí Urbalejo Ceniceros 21 , Yolanda Lugo García 11 , Ana Itamar González Ávila 11 , Jorge Duque Rodriguez 22 , Rodolfo Ruiz Luján 16 , Violeta I Rodríguez Rivera 23 , Lucio Soberanes Ramírez 24 , Pamela Elena Baez-Islas 25
Affiliations
- PMID: 35192523
- DOI: 10.3855/jidc.15126
Abstract
Introduction: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19.
Methodology: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician's criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured.
Results: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients.
Conclusions: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.
Keywords: COVID-19; JAK/STAT inhibitors; pneumonia; ruxolitinib.