Tocilizumab vs. baricitinib in hospitalized severe COVID-19 patients: results from a real-world cohort

Background Tocilizumab and baricitinib are recommended treatment options for hospitalized COVID-19 patients requiring oxygen support. Literature about its efficacy and safety in a head-to-head comparison is scarce. Methods Hospitalized COVID-19 patients requiring oxygen were treated with tocilizumab or baricitinib additionally to dexamethasone. Tocilizumab was available from February till the 19th of September 2021 and baricitinib from 21st of September. The primary outcome was in-hospital mortality. Secondary outcome parameters were progression to mechanical ventilation (MV), length-of-stay (LOS) and potential side effects. Results 159 patients (tocilizumab 68, baricitinib 91) with a mean age of 60.5 years, 64% male were included in the study. Tocilizumab patients were admitted 1 day earlier, were in a higher WHO category at the time of inclusion and had a higher CRP level on admission and treatment initiation. Patients receiving Tocilizumab were treated with remdesivir more often and only patients in the baricitinib group were treated with monoclonal antibodies. Other characteristics did not differ significantly. In-hospital mortality (18% vs. 11%, p = 0.229), progression to MV (19% vs. 11%, p = 0.173) and LOS (13 vs. 12 days, p = 0.114) did not differ between groups. Side effects were equally distributed between groups, except ALAT elevation which was significantly more often observed in the tocilizumab group (43% vs. 25%, p = 0.021). Conclusions In-hospital mortality, progression to MV and LOS were not significantly different in patients treated with tocilizumab or baricitinib additionally to standard of care. Both drugs seem equally effective but further head-to-head trials are needed..

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:51

Enthalten in:

Infection - 51(2022), 4 vom: 09. Sept., Seite 851-858

Sprache:

Englisch

Beteiligte Personen:

Karolyi, Mario [VerfasserIn]
Gruebl, Andreas [VerfasserIn]
Omid, Sara [VerfasserIn]
Saak, Magdalena [VerfasserIn]
Pawelka, Erich [VerfasserIn]
Hoepler, Wolfgang [VerfasserIn]
Kelani, Hasan [VerfasserIn]
Kuran, Avelino [VerfasserIn]
Laferl, Hermann [VerfasserIn]
Ott, Clemens [VerfasserIn]
Pereyra, David [VerfasserIn]
Santol, Jonas [VerfasserIn]
Seitz, Tamara [VerfasserIn]
Traugott, Marianna [VerfasserIn]
Assinger, Alice [VerfasserIn]
Wenisch, Christoph [VerfasserIn]
Zoufaly, Alexander [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Baricitinib
IL-6 antagonist
JAK inhibitor
Length of stay
Mechanical ventilation
Mortality
Superinfection
Tocilizumab

Anmerkungen:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s15010-022-01915-7

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2144517657

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