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Rosas J, Liaño FP, Cantó ML, Barea JMC, Beser AR, Rabasa JTA, Adsuar FM, Auli BV, López IF, Sainz AMG, Ramis PE, Pérez LR, Rebollo MLN, Lorido RH, Escolar LG. Experience With the Use of Baricitinib and Tocilizumab Monotherapy or Combined, in Patients With Interstitial Pneumonia Secondary to Coronavirus COVID19: A Real-World Study. Reumatol Clin (Engl Ed) 2022; 18:150-156. [PMID: 35277213 PMCID: PMC8902856 DOI: 10.1016/j.reumae.2020.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/28/2020] [Indexed: 01/08/2023]
Abstract
Objective To describe the experience of treatment with baricitinib (BARI) and/or tocilizumab (TCZ), in monotherapy or combined, in patients admitted for interstitial pneumonia secondary to COVID19, and for 30 days after discharge. Methods Medical records of patients admitted with COVID19 and IP with PaO2/FiO2 < 300, treated with BARI and/or TCZ, and compared with patients who did not, were retrospectively reviewed. Results Sixty patients were included; 43 (72%) are males, mean age 67 (SD: 14) years (<50 years: 17%; 51–70: 30%; >70: 53%), with 8.5 (SD: 1) days of symptoms. Sixteen (27%) patients required ICU (94% in <70 years). Fifteen (25%) patients died, 67% in >70 years; 11 (18%) patients died in the first 15 days of admission and 4 (7%) between days 16 to 30. Twenty-three (38%) patients received BARI, 12 (52%) monotherapy (Group 1), during 6 (SD: 2.6) days on average, none required ICU and 2 (17%) died. Thirty-one (52%) patients received TCZ, 20 (33%) as monotherapy (Group 2), 16 (52%) patients required ICU and 4 (20%) died. In the 11 (18%) patients who received BARI (2.8 [SD: 2.5] days average) and TCZ combined (Group 3), 3 (27%) required ICU and died. There were no severe side effects in BARI or TCZ patients. In the 17 (28%) patients who received neither BARI nor TCZ (Group 4), none required ICU and 6 (35%) died. Mean (SD) PaO2/FiO2 at admission between groups was respectively: 167 (82.3), 221 (114.9), 236 (82.3), 276 (83.2). Conclusion Treatment with BARI and TCZ did not cause serious side effects. They could be considered early in patients with NI secondary to COVID19 and impaired PaO2/PaFi.
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Affiliation(s)
- José Rosas
- Rheumatology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain.
| | | | | | | | - Amparo Raga Beser
- Pharmacy Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | | | | | - Brian Vila Auli
- Pneumology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | | | | | - Pere Esquerdo Ramis
- Internal Medicine Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | - Laura Ruiz Pérez
- Intensive Care Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | | | | | - Laura Gómez Escolar
- Gastroenterology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
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Rosas J, Liaño FP, Cantó ML, Barea JMC, Beser AR, Rabasa JTA, Adsuar FM, Auli BV, López IF, Sainz AMG, Ramis PE, Pérez LR, Rebollo MLN, Lorido RH, Escolar LG. Experience With the Use of Baricitinib and Tocilizumab Monotherapy or Combined, in Patients With Interstitial Pneumonia Secondary to Coronavirus COVID19: A Real-World Study. Reumatol Clin (Engl Ed) 2020; 18:S1699-258X(20)30271-0. [PMID: 33358361 PMCID: PMC7699160 DOI: 10.1016/j.reuma.2020.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/18/2020] [Accepted: 10/28/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To describe the experience of treatment with baricitinib (BARI) and/or tocilizumab (TCZ), in monotherapy or combined, in patients admitted for interstitial pneumonia secondary to COVID19, and for 30 days after discharge. METHODS Medical records of patients admitted with COVID19 and IP with PaO2/FiO2<300, treated with BARI and/or TCZ, and compared with patients who did not, were retrospectively reviewed. RESULTS Sixty patients were included; 43 (72%) are males, mean age 67 (SD: 14) years (<50 years: 17%; 51-70: 30%; >70: 53%), with 8.5 (SD: 1) days of symptoms. Sixteen (27%) patients required ICU (94% in <70 years). Fifteen (25%) patients died, 67% in >70 years; 11 (18%) patients died in the first 15 days of admission and 4 (7%) between days 16 to 30. Twenty-three (38%) patients received BARI, 12 (52%) monotherapy (Group 1), during 6 (SD: 2.6) days on average, none required ICU and 2 (17%) died. Thirty-one (52%) patients received TCZ, 20 (33%) as monotherapy (Group 2), 16 (52%) patients required ICU and 4 (20%) died. In the 11 (18%) patients who received BARI (2.8 [SD: 2.5] days average) and TCZ combined (Group 3), 3 (27%) required ICU and died. There were no severe side effects in BARI or TCZ patients. In the 17 (28%) patients who received neither BARI nor TCZ (Group 4), none required ICU and 6 (35%) died. Mean (SD) PaO2/FiO2 at admission between groups was respectively: 167 (82.3), 221 (114.9), 236 (82.3), 276 (83.2). CONCLUSION Treatment with BARI and TCZ did not cause serious side effects. They could be considered early in patients with NI secondary to COVID19 and impaired PaO2/PaFi.
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Affiliation(s)
- José Rosas
- Rheumatology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain.
| | | | | | | | - Amparo Raga Beser
- Pharmacy Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | | | | | - Brian Vila Auli
- Pneumology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | | | | | - Pere Esquerdo Ramis
- Internal Medicine Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | - Laura Ruiz Pérez
- Intensive Care Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | | | | | - Laura Gómez Escolar
- Gastroenterology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
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