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Adding Baricitinib Speeds Recovery for COVID-19 Pneumonia

MONDAY, Dec. 14, 2020 -- For hospitalized adults with COVID-19, baricitinib plus remdesivir is better for reducing recovery time and improving clinical status than remdesivir alone, according to a study published online Dec. 11 in the New England Journal of Medicine.

Andre C. Kalil, M.D., M.P.H., from the University of Nebraska Medical Center in Omaha, and colleagues conducted a randomized, placebo-controlled trial examining baricitinib plus remdesivir in hospitalized adults with COVID-19. A total of 1,033 patients were randomly assigned: 515 were assigned to receive baricitinib plus remdesivir (combination treatment) and 518 to placebo plus remdesivir (control).

The researchers found that the median time to recovery was seven and eight days for combination treatment versus control (rate ratio for recovery, 1.16; 95 percent confidence interval [CI], 1.01 to 1.32; P = 0.03). Patients receiving baricitinib had higher odds of improvement in clinical status at day 15 (odds ratio, 1.30; 95 percent CI, 1.0 to 1.6). For patients receiving high-flow oxygen or noninvasive ventilation at enrollment, the time to recovery was 10 and 18 days with combination treatment and control, respectively (rate ratio for recovery, 1.51; 95 percent CI, 1.10 to 2.08). The 28-day mortality was 5.1 and 7.8 percent in the combination and control groups, respectively (hazard ratio for death, 0.65; 95 percent CI, 0.39 to 1.09). Serious adverse events and new infections were less frequent in the combination versus control group.

"Results of this study demonstrated baricitinib in combination with remdesivir provided a faster median recovery time and reduced progression to ventilation or death compared to remdesivir alone in hospitalized COVID-19 patients on oxygen," Kalil said in a statement.

Gilead Sciences provided remdesivir and Eli Lilly provided baricitinib for use in this trial but neither provided any financial support.

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Posted: December 2020

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