Emerging data suggest that disease severity may be due in part to a dysregulated inflammatory response. 1 Despite the benefits of remdesivir, substantial morbidity and mortality due to Covid-19 remain. In May 2020, the first stage of the Adaptive Covid-19 Treatment Trial (ACTT-1), a randomized, double-blind, placebo-controlled trial, showed that remdesivir is an effective treatment for hospitalized adult patients with coronavirus disease 2019 (Covid-19) pneumonia. (Funded by the National Institute of Allergy and Infectious Diseases number, NCT04401579.) Introductionīaricitinib + Remdesivir for Hospitalized Adults with Covid-19 The combination was associated with fewer serious adverse events. Conclusionsīaricitinib 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. Serious adverse events were less frequent in the combination group than in the control group (16.0% vs. The 28-day mortality was 5.1% in the combination group and 7.8% in the control group (hazard ratio for death, 0.65 95% CI, 0.39 to 1.09). 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 (rate ratio for recovery, 1.51 95% CI, 1.10 to 2.08). Patients receiving baricitinib had a median time to recovery of 7 days (95% confidence interval, 6 to 8), as compared with 8 days (95% CI, 7 to 9) with control (rate ratio for recovery, 1.16 95% CI, 1.01 to 1.32 P=0.03), and a 30% higher odds of improvement in clinical status at day 15 (odds ratio, 1.3 95% CI, 1.0 to 1.6). ResultsĪ total of 1033 patients underwent randomization (with 515 assigned to combination treatment and 518 to control). The key secondary outcome was clinical status at day 15. The primary outcome was the time to recovery. All the patients received remdesivir (≤10 days) and either baricitinib (≤14 days) or placebo (control). We conducted a double-blind, randomized, placebo-controlled trial evaluating baricitinib plus remdesivir in hospitalized adults with Covid-19. The effects of combination treatment with baricitinib, a Janus kinase inhibitor, plus remdesivir are not known. Severe coronavirus disease 2019 (Covid-19) is associated with dysregulated inflammation. Original Article Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 List of authors. The most trusted, influential source of new medical knowledge and clinical best practices in the world.Įditor’s Note: This article was published on December 11, 2020, at. Information and tools for librarians about site license offerings. ![]() Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.
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