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Reumatol Clin (Engl Ed) . Experience With the Use of Baricitinib and Tocilizumab Monotherapy or Combined, in Patients With Interstitial Pneumonia Se

tetano

Editor, Senior Moderator
Reumatol Clin (Engl Ed)


. 2022 Mar;18(3):150-156.
doi: 10.1016/j.reumae.2020.10.006.
Experience With the Use of Baricitinib and Tocilizumab Monotherapy or Combined, in Patients With Interstitial Pneumonia Secondary to Coronavirus COVID19: A Real-World Study


José Rosas[SUP] 1 [/SUP], Francisco Pasquau Liaño[SUP] 2 [/SUP], Mónica Llombart Cantó[SUP] 3 [/SUP], José María Carrasco Barea[SUP] 4 [/SUP], Amparo Raga Beser[SUP] 5 [/SUP], José Tomás Algado Rabasa[SUP] 2 [/SUP], Francisco Martínez Adsuar[SUP] 6 [/SUP], Brian Vila Auli[SUP] 3 [/SUP], Isabel Fernández López[SUP] 4 [/SUP], Ana María Garijo Sainz[SUP] 2 [/SUP], Pere Esquerdo Ramis[SUP] 2 [/SUP], Laura Ruiz Pérez[SUP] 4 [/SUP], Mª Luisa Navarrete Rebollo[SUP] 4 [/SUP], Raquel Hernández Lorido[SUP] 7 [/SUP], Laura Gómez Escolar[SUP] 8 [/SUP], COVID19-HMB Group



Affiliations

Abstract

Objective: To describe the experience of treatment with baricitinib (BARI) and/or tocilizumab (TCZ), in monotherapy or combined, in patients admitted for interstitial pneumonia secondary to COVID19, and for 30 days after discharge.
Methods: Medical records of patients admitted with COVID19 and IP with PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB]<300, treated with BARI and/or TCZ, and compared with patients who did not, were retrospectively reviewed.
Results: Sixty patients were included; 43 (72%) are males, mean age 67 (SD: 14) years (<50 years: 17%; 51-70: 30%; >70: 53%), with 8.5 (SD: 1) days of symptoms. Sixteen (27%) patients required ICU (94% in <70 years). Fifteen (25%) patients died, 67% in >70 years; 11 (18%) patients died in the first 15 days of admission and 4 (7%) between days 16 to 30. Twenty-three (38%) patients received BARI, 12 (52%) monotherapy (Group 1), during 6 (SD: 2.6) days on average, none required ICU and 2 (17%) died. Thirty-one (52%) patients received TCZ, 20 (33%) as monotherapy (Group 2), 16 (52%) patients required ICU and 4 (20%) died. In the 11 (18%) patients who received BARI (2.8 [SD: 2.5] days average) and TCZ combined (Group 3), 3 (27%) required ICU and died. There were no severe side effects in BARI or TCZ patients. In the 17 (28%) patients who received neither BARI nor TCZ (Group 4), none required ICU and 6 (35%) died. Mean (SD) PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] at admission between groups was respectively: 167 (82.3), 221 (114.9), 236 (82.3), 276 (83.2).
Conclusion: Treatment with BARI and TCZ did not cause serious side effects. They could be considered early in patients with NI secondary to COVID19 and impaired PaO2/PaFi.

Keywords: Baricitinib; COVID-19; COVID19; ICU; Interstitial pneumonia; Neumonía intersticial; Tocilizumab; UCI.
 
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