HealthDay News — For critically ill hospitalized patients with COVID-19 receiving invasive mechanical ventilation or extracorporeal membrane oxygenation, baricitinib plus standard of care is associated with reduced mortality, according to a study published online February 3 in The Lancet Respiratory Medicine.

E. Wesley Ely, MD, from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues conducted a trial in 18 hospitals to examine the efficacy and safety of baricitinib plus standard of care for critically ill hospitalized adults with COVID-19 receiving invasive mechanical ventilation or extracorporeal membrane oxygenation. A total of 101 patients were enrolled and randomly assigned to either baricitinib or placebo plus standard of care (51 and 50 patients, respectively).

The researchers observed a significant reduction in 28-day all-cause mortality with baricitinib treatment vs placebo (39 vs 58%; hazard ratio, 0.54). There was also a significant reduction seen in 60-day mortality in the baricitinib group vs the placebo group (45 vs 62%; hazard ratio, 0.56). At days 28 and 60, one additional death was prevented for every 6 baricitinib-treated patients vs placebo-treated patients. No significant difference was seen between the groups in the number of ventilator-free days. The mean duration of hospitalization did not differ significantly for baricitinib- and placebo-treated patients.

“These results are consistent with the reduction in mortality observed in the less severely ill hospitalized patients in the primary COV-BARRIER study population and further support the use of baricitinib in hospitalized adults with COVID-19,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Eli Lilly, which manufactures baricitinib and funded the study.

Abstract/Full Text

Editorial