Baricitinib plus remdesivir accelerates recovery from COVID-19

In a study published in the New England Journal of Medicine on December 11, a worldwide group of researchers showed that adding baricitinib, an orally administered, selective inhibitor of Janus kinase 1 and 2, to remdesivir can reduce recovery time and accelerate improvement in clinical status among patients with COVID-19. FDA issued an emergency use authorization for the dual treatment on November 19.

In May, remdesivir was shown to be an effective treatment for hospitalized adult patients with pneumonia related to a COVID-19 infection. However, despite these benefits, substantial morbidity and mortality due to COVID- 19, and emerging data suggest that COVID-19 may cause a dysregulated inflammatory response.

The double-blind, randomized, placebo-controlled trial evaluated baricitinib plus remdesivir in hospitalized adults with COVID-19. A total of 1,033 patients received remdesivir (≤10 days) and either baricitinib (≤14 days) or placebo.

Patients receiving baricitinib had a median time to recovery of 7 days compared with a recovery time of 8 days for those receiving the placebo, and a 30% higher odds of improvement in clinical status at day 15.

Patients receiving high-flow oxygen or noninvasive ventilation at enrollment had a time to recovery of 10 days with combination treatment and 18 days with placebo. Serious adverse events were less frequent in the combination group than in the control group, as were new infections.