1. Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting
- Author
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Roberto Ovilla-Martinez, Xochitl Cota-Rangel, Jose De La Peña-Celaya, Mariana Alejandra Alvarado-Zepeda, Alejandro Jiménez Sastré, Humberto Azuara Forcelledo, Bernardino Ordoñez Rodriguez, Juan Pulido Broca, Aaron Molina Jaimes, Alejandro Muñiz-Carvajal, Maria Magdalena Bahena García, Eduardo Cervera Ceballos, Nidia Paulina Zapata Canto, Jorge Oscar García Mendez, Omar Noel García Jímenez, Jesus Alberto Salas Heredia, Javier Solis Soto, Ruben Alberto Villalobos Mendez, Gregorio Ignacio Ibarra, Cindy Ledesma de la Cruz, Nora Araujo Martinez, Jessi Juárez Lara, Cecilio Omar Ceballos Zuñiga, Felipe Vicente Villaseñor Pérez, Jose Carlos Herrera Garcia, Patricia Nuche Salazar, Alfredo Dominguez Paregrina, Bertha Arizpe Bravo, Gabriela Enciso Figueroa, Teresita Trujillo, Adriana Miguel Álvarez, Diego de Jesús García Gallegos, Alejandro Ortiz Arroyo, Claudia Ivette Solorzano Soto, Hiram Javier Jaramillo Ramírez, Ibis De la Cruz Hernández, Sergio De Gante Martínez, Guadalupe Esmeralda Montesinos Gómez, Silvia Martínez Velasco, Roberto García Graullera, Miguel Angel Vázquez López, Victor Itaí Urbalejo Ceniceros, Yolanda Lugo García, Ana Itamar González Ávila, Jorge Duque Rodriguez, Rodolfo Ruiz Luján, Violeta I. Rodríguez Rivera, Lucio Soberanes Ramírez, and Pamela Elena Baez-Islas
- Subjects
Cohort Studies ,Pyrimidines ,Treatment Outcome ,Infectious Diseases ,SARS-CoV-2 ,Virology ,Nitriles ,Humans ,Pyrazoles ,Parasitology ,General Medicine ,Microbiology ,COVID-19 Drug Treatment - Abstract
Introduction: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19. Methodology: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician’s criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured. Results: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. Conclusions: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.
- Published
- 2022
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