Combination treatment may be well-suited for patients with COVID-19 because remdesivir is a direct-acting antiviral drug, whereas baricitinib is an anti-inflammatory.
A clinical trial analyzing data from patients hospitalized with coronavirus disease 2019 (COVID-19) at University of Texas Health San Antonio and University Health demonstrated that the combination treatment of baricitinib and remdesivir was able to reduce patients’ recovery time, according to a study published in the New England Journal of Medicine.
During the Adaptive COVID-19 Treatment Trial (ACTT) 2, researchers assessed the response of hospitalized patients with COVID-19 to the combination treatment of baricitinib and remdesivir compared with remdesivir and an inactive placebo.
When given the combination treatment, patients on high oxygen by nasal canula or wearing a mask for breathing assistance when enrolled in the study had a recovery time of 10 days, whereas patients on remdesivir and the placebo had a recovery time of 18 days.
Significantly, the researchers also observed a difference in patient survival rates among the different treatment groups. In the combination treatment group, the 28-day death rate was 5.1%, whereas the rate was 7.8% in the remdesivir and placebo group.
"We are making progress in the treatment of COVID-19," said principal investigator Thomas Patterson, MD, professor and chief of infectious diseases in the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio, in a press release. "Remdesivir markedly improved recovery of critically ill patients in the first ACTT study, and baricitinib further helped patients in this second study."
Additionally, Patterson noted that the combination treatment may be well-suited together for patients with COVID-19 because remdesivir is a direct-acting antiviral drug, whereas baricitinib is an anti-inflammatory.
"I think this combination is good for a couple of reasons," Patterson said in the press release. "Baricitinib, as opposed to other anti-inflammatory drugs, has activity itself against the virus. Second, it is a pretty specific inhibitor of the inflammation."
Although baricitinib has been approved for treatment of rheumatoid arthritis, the FDA issued an emergency use authorization in November 2020 for baricitinib to be used in combination with remdesivir in treating suspected or laboratory-confirmed COVID-19 cases among hospitalized adult and pediatric patients 2 years or older who require supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation.
"We do these clinical trials to accomplish a goal, and that is to save lives," Patterson said in the press release. "At the beginning of the pandemic, we were losing a lot of patients who we are now saving, so we are getting closer to our goal."
New England Journal of Medicine publishes COVID-19 treatment trial results. San Antonio, TX: University of Texas Health Science Center at San Antonio; January 14, 2020. eurekalert.org/pub_releases/2021-01/uoth-ne011421.php. Accessed January 19, 2020.