Remdesivir and baricitinib combo reduce recovery time in Covid -19 patients: NEJM
Researchers have found in a large, international study of hospitalized patients that adding the antiinflammatory drug baricitinib to remdesivir slightly speeds up COVID-19 recovery time, especially among patients receiving supplemental oxygen without invasive ventilation, according to a The study has been published in the New England Journal of Medicine.
The ACTT-2 trial opened on May 8, 2020 and enrolled a total of 1,033 volunteer participants at sites in eight countries. Once enrolled, participants were randomized to receive a treatment regimen of either oral baricitinib tablets and intravenous (IV) remdesivir or oral placebo tablets and IV remdesivir.
In the study, the combination of baricitinib and remdesivir reduced median time to recovery in hospitalized COVID-19 patients from eight days to seven days. Patients who required high-flow oxygen or non-invasive ventilation during their hospitalization appeared to have had the largest benefit: their median time to recovery was shortened from 18 days to ten days. In addition, participants' conditions at day 15 of the study (as measured by an eight-category ordinal scale which ranked the severity of their condition) was significantly improved when they received the two therapeutics combined. Recipients of the two treatments also had slightly fewer serious adverse effects.Combination treatment was also associated with better improvement in clinical status. Moreover serious adverse events occurred less frequently in the combination group.
The authors conclude, "Baricitinib plus remdesivir was superior to remdesivir alone in reducing recovery time and accelerating improvement in clinical status, notably among patients receiving high-flow oxygen or noninvasive mechanical ventilation."
"Our results and the characteristics of baricitinib, including the fact that it is an oral drug with few drug–drug interactions and a good safety profile, lend itself to use in low-to-middle-income countries."
The researchers caution that comparing this COVID-19 treatment regimen versus those with other therapeutics, such as dexamethasone, is difficult without additional comparison studies. These results do appear to show that baricitinib plus remdesivir can benefit some COVID-19 patients and the combination deserves further clinical study, according to the researchers.
For further reference log on to:Kalil et al. Baricitinib plus remdesivir for the treatment of hospitalized adults with Covid-19. A randomized double-blind placebo-controlled trial. New England Journal of Medicine DOI: 10.1056/NEJMoa2031994 (2020)
