Baricitinib Combo Is Superior to Remdesivir Alone for COVID-19

New research has found that the combination of the anti-inflammatory baricitinib and the antiviral remdesivir lead to a reduction in the time to recovery in patients hospitalized with COVID-19.

The researchers conducted a double-blind, randomized, placebo-controlled trial in which 1033 patients receiving remdesivir also received either baricitinib (≤14 days) or placebo. The primary outcome of the study was time to recovery, and clinical status at day 15 was the secondary outcome.

Overall, those patients receiving baricitinib had a median time to recovery of 7 days compared with 8 days seen in patients given placebo (recovery rate ratio [RR] 1.6; 95% CI 1.0. to 1.32; P=0.03). Moreover, patients given baricitinib had 30% higher odds of improved status at day 15 (odds ratio 1.3; 95% CI 1.0 to 1.6).

In patients receiving high-flow oxygen or noninvasive ventilation, combination treatment with baricitinib was associated with a recovery time of 10 days compared with 18 days in patients given placebo (RR for recovery, 1.51; 95% CI, 1.10 to 2.08). Twenty-eight-day mortality rates were 5.1% and 7.8% in the combination treatment group and control group, respectively.

“Baricitinib 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. The combination was associated with fewer serious adverse events,” they concluded.

—Michael Potts

Reference:

Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with COVID-19. Published online December 11, 2020. NEJM. DOI: 10.1056/NEJMoa2031994.