학술논문
Propensity-Score Matched Analysis of the Effectiveness of Baricitinib in Patients With Coronavirus Disease 2019 (COVID-19) Using Nationwide Real-World Data: An Observational Matched Cohort Study From the Japan COVID-19 Task Force
MAJOR ARTICLE
MAJOR ARTICLE
Document Type
Report
Author
Tanaka, Hiromu; Chubachi, Shotaro; Namkoong, Ho; Sato, Yasunori; Asakura, Takanori; Lee, Ho; Azekawa, Shuhei; Otake, Shiro; Nakagawara, Kensuke; Fukushima, Takahiro; Watase, Mayuko; Sakurai, Kaori; Kusumoto, Tatsuya; Kondo, Yasushi; Masaki, Katsunori; Kamata, Hirofumi; Ishii, Makoto; Kaneko, Yuko; Hasegawa, Naoki; Ueda, Soichiro; Sasaki, Mamoru; Izumo, Takehiro; Inomata, Minoru; Miyazawa, Naoki; Kimura, Yasuhiro; Suzuki, Yusuke; Harada, Norihiro; Ichikawa, Masako; Takata, Tohru; Ishikura, Hiroyasu; Yoshiyama, Takashi; Kokuto, Hiroyuki; Murakami, Koji; Sano, Hirohito; Ueda, Tetsuya; Kuwahara, Naota; Fujiwara, Akiko; Ogura, Takashi; Inoue, Takashi; Asami, Takahiro; Mutoh, Yoshikazu; Nakachi, Ichiro; Baba, Rie; Nishi, Koichi; Tani, Mayuko; Kagyo, Junko; Hashiguchi, Mizuha; Oguma, Tsuyoshi; Asano, Koichiro; Nishikawa, Masanori; Watanabe, Hiroki; Okada, Yukinori; Koike, Ryuji; Kitagawa, Yuko; Kimura, Akinori; Imoto, Seiya; Miyano, Satoru; Ogawa, Seishi; Kanai, Takanori; Fukunaga, Koichi
Source
Open Forum Infectious Diseases. July 2023, Vol. 10 Issue 7
Subject
Language
English
ISSN
2328-8957
Abstract
Coronavirus disease 2019 (COVID-19) can be fatal, causing severe pneumonia and a cytokine storm [1], and has become a social crisis with many deaths worldwide. This pandemic has continued even [...]
Background. To determine the effectiveness of baricitinib in patients with coronavirus disease 2019 (COVID-19), investigate whether baricitinib prevents the need for invasive mechanical ventilation and identify patient subgroups that would benefit from baricitinib. Methods. This observational matched-cohort study was conducted by the Japan COVID-19 Task Force, a nationwide multicenter consortium. Patients with COVID-19 aged >18 years were identified from 70 hospitals in Japan. Among patients with confirmed COVID-19 from February 2020 to September 2021, those receiving baricitinib were propensity-score matched with controls. Results. Among 3309 patients, 144 propensity score-matched pairs were identified. Thirteen (9.0%) patients in the baricitinib group and 27 (18.8%) in the control group required invasive mechanical ventilation during the disease course (odds ratio, 0.43). Although the baricitinib group had more severe disease, there were no significant differences in the intensive care unit admission rates (odds ratio, 1.16) and mortality rates (odds ratio, 0.74) between groups. In subgroup analyses, baricitinib was associated with a significant reduction in the need for invasive mechanical ventilation in patients requiring oxygen support (odds ratio, 0.28), with rapid shadow spread on chest radiography (odds ratio, 0.11), or treated with remdesivir (odds ratio, 0.27), systemic corticosteroids (odds ratio, 0.31), or anticoagulants (odds ratio, 0.17). Conclusions. Baricitinib is effective at preventing the need for invasive mechanical ventilation in patients with COVID-19. Keywords. baricitinib; COVID-19; invasive mechanical ventilation; real-world data.
Background. To determine the effectiveness of baricitinib in patients with coronavirus disease 2019 (COVID-19), investigate whether baricitinib prevents the need for invasive mechanical ventilation and identify patient subgroups that would benefit from baricitinib. Methods. This observational matched-cohort study was conducted by the Japan COVID-19 Task Force, a nationwide multicenter consortium. Patients with COVID-19 aged >18 years were identified from 70 hospitals in Japan. Among patients with confirmed COVID-19 from February 2020 to September 2021, those receiving baricitinib were propensity-score matched with controls. Results. Among 3309 patients, 144 propensity score-matched pairs were identified. Thirteen (9.0%) patients in the baricitinib group and 27 (18.8%) in the control group required invasive mechanical ventilation during the disease course (odds ratio, 0.43). Although the baricitinib group had more severe disease, there were no significant differences in the intensive care unit admission rates (odds ratio, 1.16) and mortality rates (odds ratio, 0.74) between groups. In subgroup analyses, baricitinib was associated with a significant reduction in the need for invasive mechanical ventilation in patients requiring oxygen support (odds ratio, 0.28), with rapid shadow spread on chest radiography (odds ratio, 0.11), or treated with remdesivir (odds ratio, 0.27), systemic corticosteroids (odds ratio, 0.31), or anticoagulants (odds ratio, 0.17). Conclusions. Baricitinib is effective at preventing the need for invasive mechanical ventilation in patients with COVID-19. Keywords. baricitinib; COVID-19; invasive mechanical ventilation; real-world data.