A strong recommendation of the JAK inhibitor Baricitinib in combination with corticosteroids, for patients with severe or critical Covid 19, was reached by the Guideline Development Group (GDG) of the World Health Organization (WHO), in the 8th place. WHO Living Guideline on 13 January 2022, published in the prestigious British Medical Journal (BMJ).
Baricitinib is a micromolecular immunosuppressive agent, an inhibitor of JAK1 and JAK2 kinases. It is already approved for the treatment of active Rheumatoid Arthritis and for the treatment of moderate to severe Atopic Dermatitis in adults. As a medicinal agent, it modifies the course of Covid19 by preventing the virus from entering the body’s cells and inhibiting the cytokine cascade that causes the hyper-inflammatory reaction in severe forms of the syndrome. These actions are possible with the approved dosage of Baricitinib.
The Doctors of the Therapeutic Clinic of the Medical School of the National and Kapodistrian University of Athens, Efstathios Kastritis and Thanos Dimopoulos (Rector of EKPA) report that the recommendation was based primarily on the positive benefit / risk balance for patients with severe or critical Covid 19, resulting from signs of reduced mortality and duration of hospitalization, combined with the absence of severe adverse events.
Specifically, GDG took into account the overall results of three randomized trials in 2659 inpatients, which showed that Baricitinib administration was associated with a 38% reduction in death risk, corresponding to 45 fewer deaths per 1000 patients with severe / critical illness. In addition, it reduced the length of hospital stay by 1.4 days and the length of stay in mechanical ventilation by 3.2 days. Along with the multifaceted benefit, treatment with Baricitinib was not associated with an increase in side effects, and in particular with the possibility of discontinuation due to them.
The GDG considers the implementation of the treatment feasible for the majority of the general population, while recommending the individualized approach for groups that were not included in the studies, such as children. Baricitinib is administered orally or through the nasogastric tube.
The updated directive recommends Baricitinib as an alternative to Interleukin 6 (IL6) inhibitors. The two pharmaceutical agents have similar effects. GDG recommends that when both are available the decision should be based on parameters such as cost, availability and clinical experience while co-administration of both is NOT recommended.
Follow Skai.gr on Google News
and be the first to know all the news
.
