Adjuvant arthritis drug treatment improves COVID-19 outcomes

Combination treatment of COVID-19 patients with the antiinflammatory, arthritis drug baricitinib plus the antiviral drug remdesivir was superior to remdesivir monotherapy for cutting recovery time and improving symptoms.

“The beneficial effects of the combination treatment were seen both in the primary outcome, with a 1-day shorter time to recovery, and in the key secondary outcome, with a greater improvement in clinical status as assessed on the ordinal scale,” the authors said.

The investigators conducted a randomized, placebo-controlled trial evaluating baricitinib plus remdesivir in 1,033 adults hospitalized with Covid-19.

The subjects were treated with received remdesivir (≤10 days) and either baricitinib (≤14 days, n=515) or placebo/control (≤14 days, n=518).

The primary endpoint was the time to recovery. The key secondary endpoint was clinical status at day 15.

The researchers reported that subjects treated with baricitinib-plus-remdesivir achieved a median time to recovery of 7 days, compared with 8 days for placebo-plus-remdesivir subjects. They also achieved a 30% higher odds of improvement at day 15.

Notably, subjects on high-flow oxygen or noninvasive ventilation at enrollment achieved a median time to recovery of 10 days with combination treatment compared with 18 days for the placebo-treated cohort.

Thet reported that 28-day mortality was 5.1% in the combination treatment cohort and 7.8% in the placebo- treated cohort.

Serious adverse events appeared significantly less frequently in the combination therapy group, (16.0% vs. 21.0%, P=0.03) as did new infections (5.9% vs. 11.2%, P=0.003). The researchers concluded, “The results of this randomized, double-blind, placebo-controlled trial show that combination treatment with the antiinflammatory drug baricitinib and the antiviral drug remdesivir was safe and superior to remdesivir alone for the treatment of hospitalized patients with Covid-19 pneumonia. ……These clinical benefits were observed across different age groups, sexes, ethnic groups, and races and were independent of symptom duration or disease severity at enrollment.”