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Drugs for COVID-19: baricitinib

Erik P. Schwarz
Nr 10|2022 (56)|Page 79-84|New|doi: 10.35351/gebu.2022.10.18|15-11-2022

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The end of the COVID pandemic is not yet in sight, despite the increased immunity among the public from vaccination or infections. Knowledge about the treatment of COVID-19 has grown, and dexamethasone and tocilizumab are now part of the standard treatment of hospitalized patients with severe COVID-19. Baricitinib, a janus kinase inhibitor which has been authorised for the treatment of rheumatoid arthritis and other conditions, is now also being used to treat severely ill COVID patients. Research has shown that this drug is only moderately effective in these patients. It is questionable whether baricitinib already deserves a definitive place in the treatment of severely ill COVID patients. 
  • A meta-analysis has shown that adding the janus kinase inhibitor baricitinib to a standard treatment of COVID-19 significantly reduces mortality after 28 days compared to placebo, with a ‘number needed to treat’ (NNT) of 49.
  • The Dutch COVID guidelines, drawn up by a study group on antibiotics policy (stichting werkgroep antibioticabeleid, SWAB), do not yet include baricitinib, though it has been included in the guidelines in the United States and the United Kingdom.
  • Baricitinib can be used for severely ill COVID patients, but there is a need for further research to find out in what combination of COVID drugs baricitinib is most effective.  
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Authors

  • Erik P. Schwarz