COVID studies show that arthritic drugs may help patients recover

The results of government-sponsored clinical trials were published more than three weeks after the Food and Drug Administration issued a dual-treatment emergency license. Earlier this month, some experts said they were uncomfortable with deploying the drug without the opportunity to scrutinize the underlying data supporting their performance. Last month, the World Health Organization also recommended opposition to remdesivir as a treatment for patients with COVID due to lack of evidence to support the use of remdesivir.

Previously limited results were announced in a news release showing that hospitalized COVID patients treated with baricitinib and remdesivir recovered one day earlier than patients receiving remdesivir alone.

Given the high price of baricitinib (which can be around $ 1,500 per patient), some questioned the adoption of combination therapy and mentioned side effects such as blood clots. Because steroids like dexamethasone are cheap and widely available, some doctors have also wondered if baricitinib is worth adding. Both baricitinib and dexamethasone are thought to act by suppressing excessive inflammation, causing many severe cases of COVID.

A new paper published in the New England Journal of Medicine added some granularity to the findings and found that certain subgroups of patients benefited from the addition of far more baricitinib than other subgroups. is showing. More than 1,000 COVID inpatients were enrolled in the study, all of whom received remdesivir. People who were so ill that they needed high doses of oxygen or non-invasive ventilation recovered eight days earlier when baricitinib was included in the dosing regimen.

In these groups, “I think the data clearly support the role of baricitinib,” said Dr. Bogma Kabisen Titanji, an infectious disease specialist at Emory University who pioneered early research on baricitinib for the coronavirus. I did.

Titanji also said the data suggest that taking baricitinib in addition to remdesivir is unlikely to kill certain patients or may require a ventilator. However, these results were not uniform among study participants, as did the results that showed faster recovery times.

Dr. Lauren Henderson, a pediatric rheumatologist at Boston Children’s Hospital, said he was encouraged by the consequences of therapeutic weapons against the coronavirus and the possibility of alternatives.

However, she and several other experts added that dexamethasone may tend to be the default treatment for patients with severe COVID-19 who require respiratory assistance.

Studies have shown that dexamethasone, unlike baricitinib, reduces mortality in patients with severe COVID. Dr. Erin McCreeley, an infectious disease pharmacist at the University of Pittsburgh, said baricitinib is considered a more specialized drug and can be a disruption to the supply chain.

Some experts have pointed out another National Institutes of Health trial that makes a direct comparison of the two combination therapy regimens. One is to administer remdesivir and baricitinib to inpatients, and the other is to combine remdesivir and dexamethasone. McCreary also pointed out the importance of “determining whether there is a gradual benefit” by studying patients who received both baricitinib and dexamethasone.

Dr. Andre Karil, an infectious disease specialist at the University of Nebraska Medical Center and lead researcher in the new treatise, said dexamethasone has already become a widely accepted treatment for COVID-19, but steroids are being studied further. He said it was necessary. He cited “a number of serious safety issues” regarding drugs that justify some scrutiny.

Like other steroids, dexamethasone, which significantly slows inflammation, can have many unwanted side effects, including exacerbating conditions such as diabetes and osteoporosis.

© 2020 New York Times News Service