A class of drugs known as Janus kinase inhibitors should be the first-line therapy for patients hospitalized for COVID-19, researchers reported.
The researchers analyzed individual outcomes of nearly 13,000 adults hospitalized for COVID-19 who participated in 16 randomized trials comparing Janus kinase (JAK) inhibitors to other drugs or placebos between May 2020 and March 2022.
Overall, 11.7% of patients who received JAK inhibitors died by day 28, compared with 13.2% of those who received other treatments, such as the corticosteroid dexamethasone or agents that block IL-6 signaling.
After adjustment for individual risk factors, the odds of death by day 28 were 33% lower in the JAK inhibitor group.
“These results should inform World Health Organization COVID-19 treatment guidelines, both in the USA and Europe,” an editorial published with the study stated. “Although the pandemic has passed and COVID-19 is not nearly as rampant as it was previously, delays in disseminating and adopting best-evidence treatment practices can only be harmful.”
JAK inhibitors included tofacitinib (Xeljanz, Pfizer), baricitinib (Olumiant, Eli Lilly), and upadacitinib (Rinvoq, AbbVie).
JAK inhibitors also reduced the need for new mechanical ventilation or other respiratory support and allowed for faster discharge from hospital by approximately 1 day, with fewer serious adverse events.
The findings were consistent regardless of patients’ COVID-19 vaccination status.
“The certainty of the authors’ conclusion that JAK inhibitory therapy for the treatment of patients admitted to hospital for COVID-19 provides a significant mortality benefit is further supported when the analysis is limited to placebo-controlled studies,” the editorial noted.
Source: The Lancet Respiratory Medicine
