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Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib—a Janus kinase inhibitor, remdesivir, and dex...

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Autores principales: Izumo, Takehiro, Kuse, Naoyuki, Awano, Nobuyasu, Tone, Mari, Sakamoto, Keita, Takada, Kohei, Muto, Yutaka, Fujimoto, Kazushi, Saiki, Ayae, Ito, Yu, Matsumoto, Haruko, Inomata, Minoru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Respiratory Society. Published by Elsevier B.V. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352677/
https://www.ncbi.nlm.nih.gov/pubmed/34413006
http://dx.doi.org/10.1016/j.resinv.2021.07.004
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author Izumo, Takehiro
Kuse, Naoyuki
Awano, Nobuyasu
Tone, Mari
Sakamoto, Keita
Takada, Kohei
Muto, Yutaka
Fujimoto, Kazushi
Saiki, Ayae
Ito, Yu
Matsumoto, Haruko
Inomata, Minoru
author_facet Izumo, Takehiro
Kuse, Naoyuki
Awano, Nobuyasu
Tone, Mari
Sakamoto, Keita
Takada, Kohei
Muto, Yutaka
Fujimoto, Kazushi
Saiki, Ayae
Ito, Yu
Matsumoto, Haruko
Inomata, Minoru
author_sort Izumo, Takehiro
collection PubMed
description BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib—a Janus kinase inhibitor, remdesivir, and dexamethasone (BRD) are unknown. METHODS: Patients who received combination therapy with BRD at the Japanese Red Cross Medical Center were enrolled in the study. All patients received baricitinib (≤14 d), remdesivir (≤10 d), and dexamethasone (≤10 d). The efficacy and adverse events were evaluated. RESULTS: In total, 44 patients with severe COVID-19 were enrolled in this study. The 28-d mortality rate was low at 2.3% (1/44 patients). The need for invasive mechanical ventilation was avoided in most patients (90%, 17/19 patients). Patients who received BRD therapy had a median hospitalization duration of 11 d, time to recovery of 9 d, duration of intensive care unit stay of 6 d, duration of invasive mechanical ventilation of 5 d, and duration of supplemental oxygen therapy of 5 d. Adverse events occurred in 15 patients (34%). Liver dysfunction, thrombosis, iliopsoas hematoma, renal dysfunction, ventilator-associated pneumonia, infective endocarditis, and herpes zoster occurred in 11%, 11%, 2%, 2%, 2%, 2%, and 2% of patients, respectively. CONCLUSIONS: Combination therapy with BRD was effective in treating severe COVID-19, and the incidence rate of adverse events was low. The results of the present study are encouraging; however, further randomized clinical studies are needed.
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spelling pubmed-83526772021-08-10 Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19 Izumo, Takehiro Kuse, Naoyuki Awano, Nobuyasu Tone, Mari Sakamoto, Keita Takada, Kohei Muto, Yutaka Fujimoto, Kazushi Saiki, Ayae Ito, Yu Matsumoto, Haruko Inomata, Minoru Respir Investig Original Article BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib—a Janus kinase inhibitor, remdesivir, and dexamethasone (BRD) are unknown. METHODS: Patients who received combination therapy with BRD at the Japanese Red Cross Medical Center were enrolled in the study. All patients received baricitinib (≤14 d), remdesivir (≤10 d), and dexamethasone (≤10 d). The efficacy and adverse events were evaluated. RESULTS: In total, 44 patients with severe COVID-19 were enrolled in this study. The 28-d mortality rate was low at 2.3% (1/44 patients). The need for invasive mechanical ventilation was avoided in most patients (90%, 17/19 patients). Patients who received BRD therapy had a median hospitalization duration of 11 d, time to recovery of 9 d, duration of intensive care unit stay of 6 d, duration of invasive mechanical ventilation of 5 d, and duration of supplemental oxygen therapy of 5 d. Adverse events occurred in 15 patients (34%). Liver dysfunction, thrombosis, iliopsoas hematoma, renal dysfunction, ventilator-associated pneumonia, infective endocarditis, and herpes zoster occurred in 11%, 11%, 2%, 2%, 2%, 2%, and 2% of patients, respectively. CONCLUSIONS: Combination therapy with BRD was effective in treating severe COVID-19, and the incidence rate of adverse events was low. The results of the present study are encouraging; however, further randomized clinical studies are needed. The Japanese Respiratory Society. Published by Elsevier B.V. 2021-11 2021-08-10 /pmc/articles/PMC8352677/ /pubmed/34413006 http://dx.doi.org/10.1016/j.resinv.2021.07.004 Text en © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Izumo, Takehiro
Kuse, Naoyuki
Awano, Nobuyasu
Tone, Mari
Sakamoto, Keita
Takada, Kohei
Muto, Yutaka
Fujimoto, Kazushi
Saiki, Ayae
Ito, Yu
Matsumoto, Haruko
Inomata, Minoru
Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
title Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
title_full Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
title_fullStr Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
title_full_unstemmed Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
title_short Clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe COVID-19
title_sort clinical impact of combination therapy with baricitinib, remdesivir, and dexamethasone in patients with severe covid-19
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352677/
https://www.ncbi.nlm.nih.gov/pubmed/34413006
http://dx.doi.org/10.1016/j.resinv.2021.07.004
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