Combination therapy with predicted body weight-based dexamethasone, remdesivir, and baricitinib in patients with COVID-19 pneumonia : A single-center retrospective cohort study during 5th wave in Japan
Copyright © 2023 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved..
BACKGROUND: Dexamethasone, remdesivir, and baricitinib reduce mortality in patients with coronavirus disease 2019 (COVID-19). A single-arm study using combination therapy with all three drugs reported low mortality in patients with severe COVID-19. In this clinical setting, whether dexamethasone administered as a fixed dose of 6 mg has sufficient inflammatory modulation effects of reducing lung injury has been debated.
METHODS: This single-center retrospective study was conducted to compare the treatment strategies/management in different time periods. A total of 152 patients admitted with COVID-19 pneumonia who required oxygen therapy were included in this study. A predicted body weight (PBW)-based dose of dexamethasone with remdesivir and baricitinib was administered between May and June 2021. After this period, patients were administered a fixed dose of dexamethasone at 6.6 mg/day between July and August 2021. The additional respiratory support frequency of high-flow nasal cannula, noninvasive ventilation, and mechanical ventilation was analyzed. Moreover, the Kaplan-Meier method was used to analyze the duration of oxygen therapy and the 30-day discharge alive rate, and they were compared using the log-rank test.
RESULTS: Intervention and prognostic comparisons were performed in 64 patients with PBW-based and 88 with fixed-dose groups. The frequency of infection or additional respiratory support did not differ statistically. The cumulative incidence of being discharged alive or oxygen-free rate within 30 days did not differ between the groups.
CONCLUSIONS: In patients with COVID-19 pneumonia who required oxygen therapy, combination therapy with PBW-based dexamethasone, remdesivir, and baricitinib might not shorten the hospital stay's length or oxygen therapy's duration.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:61 |
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| Enthalten in: |
Respiratory investigation - 61(2023), 4 vom: 25. Juli, Seite 438-444 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hirasawa, Yasutaka [VerfasserIn] |
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| Links: |
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| Themen: |
3QKI37EEHE |
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| Anmerkungen: |
Date Completed 19.06.2023 Date Revised 19.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.resinv.2023.03.009 |
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| funding: |
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| PPN (Katalog-ID): |
NLM356231380 |
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| 100 | 1 | |a Hirasawa, Yasutaka |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Combination therapy with predicted body weight-based dexamethasone, remdesivir, and baricitinib in patients with COVID-19 pneumonia |b A single-center retrospective cohort study during 5th wave in Japan |
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| 500 | |a published: Print-Electronic | ||
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| 520 | |a Copyright © 2023 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Dexamethasone, remdesivir, and baricitinib reduce mortality in patients with coronavirus disease 2019 (COVID-19). A single-arm study using combination therapy with all three drugs reported low mortality in patients with severe COVID-19. In this clinical setting, whether dexamethasone administered as a fixed dose of 6 mg has sufficient inflammatory modulation effects of reducing lung injury has been debated | ||
| 520 | |a METHODS: This single-center retrospective study was conducted to compare the treatment strategies/management in different time periods. A total of 152 patients admitted with COVID-19 pneumonia who required oxygen therapy were included in this study. A predicted body weight (PBW)-based dose of dexamethasone with remdesivir and baricitinib was administered between May and June 2021. After this period, patients were administered a fixed dose of dexamethasone at 6.6 mg/day between July and August 2021. The additional respiratory support frequency of high-flow nasal cannula, noninvasive ventilation, and mechanical ventilation was analyzed. Moreover, the Kaplan-Meier method was used to analyze the duration of oxygen therapy and the 30-day discharge alive rate, and they were compared using the log-rank test | ||
| 520 | |a RESULTS: Intervention and prognostic comparisons were performed in 64 patients with PBW-based and 88 with fixed-dose groups. The frequency of infection or additional respiratory support did not differ statistically. The cumulative incidence of being discharged alive or oxygen-free rate within 30 days did not differ between the groups | ||
| 520 | |a CONCLUSIONS: In patients with COVID-19 pneumonia who required oxygen therapy, combination therapy with PBW-based dexamethasone, remdesivir, and baricitinib might not shorten the hospital stay's length or oxygen therapy's duration | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Dexamethasone | |
| 650 | 4 | |a Pneumonia | |
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| 700 | 1 | |a Terada, Jiro |e verfasserin |4 aut | |
| 700 | 1 | |a Shionoya, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Fujikawa, Atsushi |e verfasserin |4 aut | |
| 700 | 1 | |a Isaka, Yuri |e verfasserin |4 aut | |
| 700 | 1 | |a Takeshita, Yuichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kinouchi, Toru |e verfasserin |4 aut | |
| 700 | 1 | |a Koshikawa, Ken |e verfasserin |4 aut | |
| 700 | 1 | |a Tajima, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kinoshita, Taku |e verfasserin |4 aut | |
| 700 | 1 | |a Tada, Yuji |e verfasserin |4 aut | |
| 700 | 1 | |a Tatsumi, Koichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Tsushima, Kenji |e verfasserin |4 aut | |
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