Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19
Remdesivir and Baricitinib is an effective treatment for hospitalized adult patients. While baricitinib treatment was associated with improved oxygenation and reduced inflammatory markers, Remdesivir treatment was found to have substantial morbidity and mortality outcomes. A.C. Kalil and colleagues published a study in The New England Journal of Medicine under the title “Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19“. The summary of the study is given below:
Objective
To investigate whether the combination of baricitinib plus remdesivir was better than remdesivir alone
Method:
This is a double-blind, randomized, placebo-controlled trial including hospitalized adults with Covid-19. All the patients were administered with remdesivir for less than 10 days and either placebo or baricitinib for less than 14 days. The main outcome was the time to recovery. Another key outcome was the clinical status on day 15.
Findings:
The study reports that in hospitalized patients with Covid-19 pneumonia, combination treatment with the anti-inflammatory drug baricitinib and the antiviral drug remdesivir was superior and safe to remdesivir alone. The combination treatment was beneficial in the primary outcome resulting 1-day shorter recovery time. While considering the secondary outcomes, a greater improvement in clinical status was also observed. Both the survival rate and the time-to-death analyses favored combination treatment. Additionally, these clinical benefits were observed across different sexes, age groups, races, and ethnic groups and were independent of symptom duration or disease severity at enrollment. This therapy may have an effect in lowering the hospital-associated risk of thrombosis, nosocomial infections, and errors in hospital drug administration.
As compare to remdesivir, this combination therapy resulted in less incidence of adverse events, serious adverse events, adverse events that led to discontinuation of the trial drug, serious adverse events resulting in fatal outcome, and infection-related adverse events.