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Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study

Background and Objectives: Tocilizumab and baricitinib have been observed to improve the outcomes of patients with coronavirus disease 2019 (COVID-19). However, a comparative evaluation of these drugs has not been performed. Materials and Methods: A retrospective, single-center study was conducted u...

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Autores principales: Kojima, Yuichi, Nakakubo, Sho, Takei, Nozomu, Kamada, Keisuke, Yamashita, Yu, Nakamura, Junichi, Matsumoto, Munehiro, Horii, Hiroshi, Sato, Kazuki, Shima, Hideki, Suzuki, Masaru, Konno, Satoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9030469/
https://www.ncbi.nlm.nih.gov/pubmed/35454352
http://dx.doi.org/10.3390/medicina58040513
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author Kojima, Yuichi
Nakakubo, Sho
Takei, Nozomu
Kamada, Keisuke
Yamashita, Yu
Nakamura, Junichi
Matsumoto, Munehiro
Horii, Hiroshi
Sato, Kazuki
Shima, Hideki
Suzuki, Masaru
Konno, Satoshi
author_facet Kojima, Yuichi
Nakakubo, Sho
Takei, Nozomu
Kamada, Keisuke
Yamashita, Yu
Nakamura, Junichi
Matsumoto, Munehiro
Horii, Hiroshi
Sato, Kazuki
Shima, Hideki
Suzuki, Masaru
Konno, Satoshi
author_sort Kojima, Yuichi
collection PubMed
description Background and Objectives: Tocilizumab and baricitinib have been observed to improve the outcomes of patients with coronavirus disease 2019 (COVID-19). However, a comparative evaluation of these drugs has not been performed. Materials and Methods: A retrospective, single-center study was conducted using the data of COVID-19 patients admitted to Hokkaido University hospital between April 2020 and September 2021, who were treated with tocilizumab or baricitinib. The clinical characteristics of the patients who received tocilizumab were compared to those of patients who received baricitinib. Univariate and multivariate logistic regression analyses of the outcomes of all-cause mortality and improvement in respiratory status were performed. The development of secondary infection events was analyzed using the Kaplan–Meier method and the log-rank test. Results: Of the 459 patients hospitalized with COVID-19 during the study, 64 received tocilizumab treatment and 34 baricitinib treatment, and those 98 patients were included in the study. Most patients were treated with concomitant steroids and exhibited the same severity level at the initiation of drug treatment. When compared to each other, neither tocilizumab nor baricitinib use were associated with all-cause mortality or improvement in respiratory status within 28 days from drug administration. Conclusions: Age, chronic renal disease and early administration of TCZ or BRT from the onset of COVID-19 were independent prognostic factors for all-cause mortality, whereas anti-viral drug use and the severity of COVID-19 at baseline were associated with an improvement in respiratory status. Secondary infection-free survival rates of patients treated with tocilizumab and those treated with baricitinib did not significantly differ. The results suggest that both tocilizumab and baricitinib could be clinically equivalent agents of choice in treatment of COVID-19.
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spelling pubmed-90304692022-04-23 Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study Kojima, Yuichi Nakakubo, Sho Takei, Nozomu Kamada, Keisuke Yamashita, Yu Nakamura, Junichi Matsumoto, Munehiro Horii, Hiroshi Sato, Kazuki Shima, Hideki Suzuki, Masaru Konno, Satoshi Medicina (Kaunas) Article Background and Objectives: Tocilizumab and baricitinib have been observed to improve the outcomes of patients with coronavirus disease 2019 (COVID-19). However, a comparative evaluation of these drugs has not been performed. Materials and Methods: A retrospective, single-center study was conducted using the data of COVID-19 patients admitted to Hokkaido University hospital between April 2020 and September 2021, who were treated with tocilizumab or baricitinib. The clinical characteristics of the patients who received tocilizumab were compared to those of patients who received baricitinib. Univariate and multivariate logistic regression analyses of the outcomes of all-cause mortality and improvement in respiratory status were performed. The development of secondary infection events was analyzed using the Kaplan–Meier method and the log-rank test. Results: Of the 459 patients hospitalized with COVID-19 during the study, 64 received tocilizumab treatment and 34 baricitinib treatment, and those 98 patients were included in the study. Most patients were treated with concomitant steroids and exhibited the same severity level at the initiation of drug treatment. When compared to each other, neither tocilizumab nor baricitinib use were associated with all-cause mortality or improvement in respiratory status within 28 days from drug administration. Conclusions: Age, chronic renal disease and early administration of TCZ or BRT from the onset of COVID-19 were independent prognostic factors for all-cause mortality, whereas anti-viral drug use and the severity of COVID-19 at baseline were associated with an improvement in respiratory status. Secondary infection-free survival rates of patients treated with tocilizumab and those treated with baricitinib did not significantly differ. The results suggest that both tocilizumab and baricitinib could be clinically equivalent agents of choice in treatment of COVID-19. MDPI 2022-04-04 /pmc/articles/PMC9030469/ /pubmed/35454352 http://dx.doi.org/10.3390/medicina58040513 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kojima, Yuichi
Nakakubo, Sho
Takei, Nozomu
Kamada, Keisuke
Yamashita, Yu
Nakamura, Junichi
Matsumoto, Munehiro
Horii, Hiroshi
Sato, Kazuki
Shima, Hideki
Suzuki, Masaru
Konno, Satoshi
Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study
title Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study
title_full Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study
title_fullStr Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study
title_full_unstemmed Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study
title_short Comparative Efficacy of Tocilizumab and Baricitinib Administration in COVID-19 Treatment: A Retrospective Cohort Study
title_sort comparative efficacy of tocilizumab and baricitinib administration in covid-19 treatment: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9030469/
https://www.ncbi.nlm.nih.gov/pubmed/35454352
http://dx.doi.org/10.3390/medicina58040513
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