Baricitinib Combo for COVID-19 Accelerates Recovery, Study S
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Among people hospitalized with COVID-19, a combination of baricitinib and remdesivir reduces the median time to recovery compared with remdesivir plus placebo, according to trial results published in the New England Journal of Medicine.

Covid-19 is associated with dysregulated inflammation. The effects of combination treatment with baricitinib, a Janus kinase inhibitor, plus remdesivir are not known.

Researchers conducted a double-blind, randomized, placebo-controlled trial evaluating baricitinib plus remdesivir in hospitalized adults with Covid-19. All the patients received remdesivir (less than 10 days) and either baricitinib (less than 14 days) or placebo (control). The primary outcome was the time to recovery. The key secondary outcome was clinical status at day 15.

Results:
-- A total of 1033 patients underwent randomization (with 515 assigned to combination treatment and 518 to control).

-- Patients receiving baricitinib had a median time to recovery of 7 days, as compared with 8 days with control 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 control.

-- The 28-day mortality was 5.1% in the combination group and 7.8% in the control group.

-- Serious adverse events were less frequent in the combination group than in the control group, as were new infections.

Conclusively, Baricitinib plus remdesivir was superior to remdesivir alone in reducing recovery time and accelerating improvement in clinical status among patients with Covid-19, notably among those receiving high-flow oxygen or noninvasive ventilation. The combination was associated with fewer serious adverse events.

Source: https://www.nejm.org/doi/10.1056/NEJMoa2031994
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