Anakinra versus Baricitinib: Different Strategies for Patients Hospitalized with COVID-19
Background: Immunomodulatory drugs have been used in patients with severe COVID-19. The objective of this study was to evaluate the effects of two different strategies, based either on an interleukin-1 inhibitor, anakinra, or on a JAK inhibitor, such as baricitinib, on the survival of patients hospi...
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| Veröffentlicht in: | Journal of clinical medicine 2021-09, Vol.10 (17), p.4019 |
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| creator | García-García, José A Pérez-Quintana, Marta Ramos-Giráldez, Consuelo Cebrián-González, Isabel Martín-Ponce, María L del Valle-Villagrán, José Navarro-Puerto, María A Sánchez-Villegas, Jorge Gómez-Herreros, Rocío Manoja-Bustos, Isabel León-Martí, Daniel Serrano-Rodríguez, Lucía de Miguel-Albarreal, Alejandra Velasco-Romero, María J Mula-Falcón, Francisco Fernández-Pérez, Pilar Melguizo-Moya, Isabel Pérez-Quintana, María J Romero-Molina, Guillermo Vergara-López, Salvador Marenco-de la Fuente, José L Marín-Martín, Jorge Mira-Escarti, José A |
| description | Background: Immunomodulatory drugs have been used in patients with severe COVID-19. The objective of this study was to evaluate the effects of two different strategies, based either on an interleukin-1 inhibitor, anakinra, or on a JAK inhibitor, such as baricitinib, on the survival of patients hospitalized with COVID-19 pneumonia. Methods: Individuals admitted to two hospitals because of COVID-19 were included if they fulfilled the clinical, radiological, and laboratory criteria for moderate-to-severe disease. Patients were classified according to the first immunomodulatory drug prescribed: anakinra or baricitinib. All subjects were concomitantly treated with corticosteroids, in addition to standard care. The main outcomes were the need for invasive mechanical ventilation (IMV) and in-hospital death. Statistical analysis included propensity score matching and Cox regression model. Results: The study subjects included 125 and 217 individuals in the anakinra and baricitinib groups, respectively. IMV was required in 13 (10.4%) and 10 (4.6%) patients, respectively (p = 0.039). During this period, 22 (17.6%) and 36 (16.6%) individuals died in both groups (p = 0.811). Older age, low functional status, high comorbidity, need for IMV, elevated lactate dehydrogenase, and use of a high flow of oxygen at initially were found to be associated with worse clinical outcomes. No differences according to the immunomodulatory therapy used were observed. For most of the deceased individuals, early interruption of anakinra or baricitinib had occurred at the time of their admission to the intensive care unit. Conclusions: Similar mortality is observed in patients treated with anakinra or baricitinib plus corticosteroids. |
| doi_str_mv | 10.3390/jcm10174019 |
| format | Article |
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The objective of this study was to evaluate the effects of two different strategies, based either on an interleukin-1 inhibitor, anakinra, or on a JAK inhibitor, such as baricitinib, on the survival of patients hospitalized with COVID-19 pneumonia. Methods: Individuals admitted to two hospitals because of COVID-19 were included if they fulfilled the clinical, radiological, and laboratory criteria for moderate-to-severe disease. Patients were classified according to the first immunomodulatory drug prescribed: anakinra or baricitinib. All subjects were concomitantly treated with corticosteroids, in addition to standard care. The main outcomes were the need for invasive mechanical ventilation (IMV) and in-hospital death. Statistical analysis included propensity score matching and Cox regression model. Results: The study subjects included 125 and 217 individuals in the anakinra and baricitinib groups, respectively. IMV was required in 13 (10.4%) and 10 (4.6%) patients, respectively (p = 0.039). During this period, 22 (17.6%) and 36 (16.6%) individuals died in both groups (p = 0.811). Older age, low functional status, high comorbidity, need for IMV, elevated lactate dehydrogenase, and use of a high flow of oxygen at initially were found to be associated with worse clinical outcomes. No differences according to the immunomodulatory therapy used were observed. For most of the deceased individuals, early interruption of anakinra or baricitinib had occurred at the time of their admission to the intensive care unit. Conclusions: Similar mortality is observed in patients treated with anakinra or baricitinib plus corticosteroids.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10174019</identifier><identifier>PMID: 34501467</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Activities of daily living ; Anticoagulants ; Clinical medicine ; Clinical outcomes ; Clinical trials ; Coronaviruses ; COVID-19 ; Cytokine storm ; Drug dosages ; Hospitalization ; Infections ; Intubation ; Laboratories ; Mortality ; Pneumonia ; Severe acute respiratory syndrome coronavirus 2 ; Steroids ; Variables ; Ventilators</subject><ispartof>Journal of clinical medicine, 2021-09, Vol.10 (17), p.4019</ispartof><rights>2021 by the authors. 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/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-17c98245e7f2a2321ec91c70203325d833b5b4581fb515487dc9eb625f89b9693</citedby><cites>FETCH-LOGICAL-c386t-17c98245e7f2a2321ec91c70203325d833b5b4581fb515487dc9eb625f89b9693</cites><orcidid>0000-0002-7563-1056 ; 0000-0002-3141-6223 ; 0000-0001-8419-7151 ; 0000-0002-8646-8143 ; 0000-0003-2294-9797</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432474/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432474/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>García-García, José A</creatorcontrib><creatorcontrib>Pérez-Quintana, Marta</creatorcontrib><creatorcontrib>Ramos-Giráldez, Consuelo</creatorcontrib><creatorcontrib>Cebrián-González, Isabel</creatorcontrib><creatorcontrib>Martín-Ponce, María L</creatorcontrib><creatorcontrib>del Valle-Villagrán, José</creatorcontrib><creatorcontrib>Navarro-Puerto, María A</creatorcontrib><creatorcontrib>Sánchez-Villegas, Jorge</creatorcontrib><creatorcontrib>Gómez-Herreros, Rocío</creatorcontrib><creatorcontrib>Manoja-Bustos, Isabel</creatorcontrib><creatorcontrib>León-Martí, Daniel</creatorcontrib><creatorcontrib>Serrano-Rodríguez, Lucía</creatorcontrib><creatorcontrib>de Miguel-Albarreal, Alejandra</creatorcontrib><creatorcontrib>Velasco-Romero, María J</creatorcontrib><creatorcontrib>Mula-Falcón, Francisco</creatorcontrib><creatorcontrib>Fernández-Pérez, Pilar</creatorcontrib><creatorcontrib>Melguizo-Moya, Isabel</creatorcontrib><creatorcontrib>Pérez-Quintana, María J</creatorcontrib><creatorcontrib>Romero-Molina, Guillermo</creatorcontrib><creatorcontrib>Vergara-López, Salvador</creatorcontrib><creatorcontrib>Marenco-de la Fuente, José L</creatorcontrib><creatorcontrib>Marín-Martín, Jorge</creatorcontrib><creatorcontrib>Mira-Escarti, José A</creatorcontrib><title>Anakinra versus Baricitinib: Different Strategies for Patients Hospitalized with COVID-19</title><title>Journal of clinical medicine</title><description>Background: Immunomodulatory drugs have been used in patients with severe COVID-19. The objective of this study was to evaluate the effects of two different strategies, based either on an interleukin-1 inhibitor, anakinra, or on a JAK inhibitor, such as baricitinib, on the survival of patients hospitalized with COVID-19 pneumonia. Methods: Individuals admitted to two hospitals because of COVID-19 were included if they fulfilled the clinical, radiological, and laboratory criteria for moderate-to-severe disease. Patients were classified according to the first immunomodulatory drug prescribed: anakinra or baricitinib. All subjects were concomitantly treated with corticosteroids, in addition to standard care. The main outcomes were the need for invasive mechanical ventilation (IMV) and in-hospital death. Statistical analysis included propensity score matching and Cox regression model. Results: The study subjects included 125 and 217 individuals in the anakinra and baricitinib groups, respectively. IMV was required in 13 (10.4%) and 10 (4.6%) patients, respectively (p = 0.039). During this period, 22 (17.6%) and 36 (16.6%) individuals died in both groups (p = 0.811). Older age, low functional status, high comorbidity, need for IMV, elevated lactate dehydrogenase, and use of a high flow of oxygen at initially were found to be associated with worse clinical outcomes. No differences according to the immunomodulatory therapy used were observed. For most of the deceased individuals, early interruption of anakinra or baricitinib had occurred at the time of their admission to the intensive care unit. Conclusions: Similar mortality is observed in patients treated with anakinra or baricitinib plus corticosteroids.</description><subject>Activities of daily living</subject><subject>Anticoagulants</subject><subject>Clinical medicine</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Cytokine storm</subject><subject>Drug dosages</subject><subject>Hospitalization</subject><subject>Infections</subject><subject>Intubation</subject><subject>Laboratories</subject><subject>Mortality</subject><subject>Pneumonia</subject><subject>Severe acute respiratory syndrome coronavirus 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Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>García-García, José A</au><au>Pérez-Quintana, Marta</au><au>Ramos-Giráldez, Consuelo</au><au>Cebrián-González, Isabel</au><au>Martín-Ponce, María L</au><au>del Valle-Villagrán, José</au><au>Navarro-Puerto, María A</au><au>Sánchez-Villegas, Jorge</au><au>Gómez-Herreros, Rocío</au><au>Manoja-Bustos, Isabel</au><au>León-Martí, Daniel</au><au>Serrano-Rodríguez, Lucía</au><au>de Miguel-Albarreal, Alejandra</au><au>Velasco-Romero, María J</au><au>Mula-Falcón, Francisco</au><au>Fernández-Pérez, Pilar</au><au>Melguizo-Moya, Isabel</au><au>Pérez-Quintana, María J</au><au>Romero-Molina, Guillermo</au><au>Vergara-López, Salvador</au><au>Marenco-de la Fuente, José L</au><au>Marín-Martín, Jorge</au><au>Mira-Escarti, José A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anakinra versus Baricitinib: Different Strategies for Patients Hospitalized with COVID-19</atitle><jtitle>Journal of clinical medicine</jtitle><date>2021-09-06</date><risdate>2021</risdate><volume>10</volume><issue>17</issue><spage>4019</spage><pages>4019-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Background: Immunomodulatory drugs have been used in patients with severe COVID-19. The objective of this study was to evaluate the effects of two different strategies, based either on an interleukin-1 inhibitor, anakinra, or on a JAK inhibitor, such as baricitinib, on the survival of patients hospitalized with COVID-19 pneumonia. Methods: Individuals admitted to two hospitals because of COVID-19 were included if they fulfilled the clinical, radiological, and laboratory criteria for moderate-to-severe disease. Patients were classified according to the first immunomodulatory drug prescribed: anakinra or baricitinib. All subjects were concomitantly treated with corticosteroids, in addition to standard care. The main outcomes were the need for invasive mechanical ventilation (IMV) and in-hospital death. Statistical analysis included propensity score matching and Cox regression model. Results: The study subjects included 125 and 217 individuals in the anakinra and baricitinib groups, respectively. IMV was required in 13 (10.4%) and 10 (4.6%) patients, respectively (p = 0.039). During this period, 22 (17.6%) and 36 (16.6%) individuals died in both groups (p = 0.811). Older age, low functional status, high comorbidity, need for IMV, elevated lactate dehydrogenase, and use of a high flow of oxygen at initially were found to be associated with worse clinical outcomes. No differences according to the immunomodulatory therapy used were observed. For most of the deceased individuals, early interruption of anakinra or baricitinib had occurred at the time of their admission to the intensive care unit. Conclusions: Similar mortality is observed in patients treated with anakinra or baricitinib plus corticosteroids.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34501467</pmid><doi>10.3390/jcm10174019</doi><orcidid>https://orcid.org/0000-0002-7563-1056</orcidid><orcidid>https://orcid.org/0000-0002-3141-6223</orcidid><orcidid>https://orcid.org/0000-0001-8419-7151</orcidid><orcidid>https://orcid.org/0000-0002-8646-8143</orcidid><orcidid>https://orcid.org/0000-0003-2294-9797</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2077-0383 |
| ispartof | Journal of clinical medicine, 2021-09, Vol.10 (17), p.4019 |
| issn | 2077-0383 2077-0383 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8432474 |
| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Activities of daily living Anticoagulants Clinical medicine Clinical outcomes Clinical trials Coronaviruses COVID-19 Cytokine storm Drug dosages Hospitalization Infections Intubation Laboratories Mortality Pneumonia Severe acute respiratory syndrome coronavirus 2 Steroids Variables Ventilators |
| title | Anakinra versus Baricitinib: Different Strategies for Patients Hospitalized with COVID-19 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T09%3A07%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Anakinra%20versus%20Baricitinib:%20Different%20Strategies%20for%20Patients%20Hospitalized%20with%20COVID-19&rft.jtitle=Journal%20of%20clinical%20medicine&rft.au=Garc%C3%ADa-Garc%C3%ADa,%20Jos%C3%A9%20A&rft.date=2021-09-06&rft.volume=10&rft.issue=17&rft.spage=4019&rft.pages=4019-&rft.issn=2077-0383&rft.eissn=2077-0383&rft_id=info:doi/10.3390/jcm10174019&rft_dat=%3Cproquest_pubme%3E2571317034%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2571317034&rft_id=info:pmid/34501467&rfr_iscdi=true |