tetano
Editor, Senior Moderator
Respir Investig
. 2021 Aug 10;S2212-5345(21)00125-8.
doi: 10.1016/j.resinv.2021.07.004. Online ahead of print.
Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
Takehiro Izumo[SUP] 1 [/SUP], Naoyuki Kuse[SUP] 2 [/SUP], Nobuyasu Awano[SUP] 2 [/SUP], Mari Tone[SUP] 2 [/SUP], Keita Sakamoto[SUP] 2 [/SUP], Kohei Takada[SUP] 2 [/SUP], Yutaka Muto[SUP] 2 [/SUP], Kazushi Fujimoto[SUP] 2 [/SUP], Ayae Saiki[SUP] 2 [/SUP], Yu Ito[SUP] 2 [/SUP], Haruko Matsumoto[SUP] 2 [/SUP], Minoru Inomata[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib-a Janus kinase inhibitor, remdesivir, and dexamethasone (BRD) are unknown.
Methods: Patients who received combination therapy with BRD at the Japanese Red Cross Medical Center were enrolled in the study. All patients received baricitinib (≤14 d), remdesivir (≤10 d), and dexamethasone (≤10 d). The efficacy and adverse events were evaluated.
Results: In total, 44 patients with severe COVID-19 were enrolled in this study. The 28-d mortality rate was low at 2.3% (1/44 patients). The need for invasive mechanical ventilation was avoided in most patients (90%, 17/19 patients). Patients who received BRD therapy had a median hospitalization duration of 11 d, time to recovery of 9 d, duration of intensive care unit stay of 6 d, duration of invasive mechanical ventilation of 5 d, and duration of supplemental oxygen therapy of 5 d. Adverse events occurred in 15 patients (34%). Liver dysfunction, thrombosis, iliopsoas hematoma, renal dysfunction, ventilator-associated pneumonia, infective endocarditis, and herpes zoster occurred in 11%, 11%, 2%, 2%, 2%, 2%, and 2% of patients, respectively.
Conclusions: Combination therapy with BRD was effective in treating severe COVID-19, and the incidence rate of adverse events was low. The results of the present study are encouraging; however, further randomized clinical studies are needed.
Keywords: Acute respiratory distress syndrome; Adverse event; Coronavirus disease 2019; Efficacy; Severe acute respiratory syndrome coronavirus 2.
. 2021 Aug 10;S2212-5345(21)00125-8.
doi: 10.1016/j.resinv.2021.07.004. Online ahead of print.
Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
Takehiro Izumo[SUP] 1 [/SUP], Naoyuki Kuse[SUP] 2 [/SUP], Nobuyasu Awano[SUP] 2 [/SUP], Mari Tone[SUP] 2 [/SUP], Keita Sakamoto[SUP] 2 [/SUP], Kohei Takada[SUP] 2 [/SUP], Yutaka Muto[SUP] 2 [/SUP], Kazushi Fujimoto[SUP] 2 [/SUP], Ayae Saiki[SUP] 2 [/SUP], Yu Ito[SUP] 2 [/SUP], Haruko Matsumoto[SUP] 2 [/SUP], Minoru Inomata[SUP] 2 [/SUP]
Affiliations
- PMID: 34413006
- DOI: 10.1016/j.resinv.2021.07.004
Abstract
Background: Coronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib-a Janus kinase inhibitor, remdesivir, and dexamethasone (BRD) are unknown.
Methods: Patients who received combination therapy with BRD at the Japanese Red Cross Medical Center were enrolled in the study. All patients received baricitinib (≤14 d), remdesivir (≤10 d), and dexamethasone (≤10 d). The efficacy and adverse events were evaluated.
Results: In total, 44 patients with severe COVID-19 were enrolled in this study. The 28-d mortality rate was low at 2.3% (1/44 patients). The need for invasive mechanical ventilation was avoided in most patients (90%, 17/19 patients). Patients who received BRD therapy had a median hospitalization duration of 11 d, time to recovery of 9 d, duration of intensive care unit stay of 6 d, duration of invasive mechanical ventilation of 5 d, and duration of supplemental oxygen therapy of 5 d. Adverse events occurred in 15 patients (34%). Liver dysfunction, thrombosis, iliopsoas hematoma, renal dysfunction, ventilator-associated pneumonia, infective endocarditis, and herpes zoster occurred in 11%, 11%, 2%, 2%, 2%, 2%, and 2% of patients, respectively.
Conclusions: Combination therapy with BRD was effective in treating severe COVID-19, and the incidence rate of adverse events was low. The results of the present study are encouraging; however, further randomized clinical studies are needed.
Keywords: Acute respiratory distress syndrome; Adverse event; Coronavirus disease 2019; Efficacy; Severe acute respiratory syndrome coronavirus 2.