부산대학교 도서관

Overwhelming inflammatory reactions contribute to respiratory distress in patients with COVID-19. Ruxolitinib is a JAK1/JAK2 inhibitor with potent anti-inflammatory properties. We report on a prospective, observational study in 34 patients with COVID-19 who received ruxolitinib on a compassionate-use protocol. Patients had severe pulmonary disease defined by pulmonary infiltrates on imaging and an oxygen saturation [less than or equal to] 93% in air and/or PaO2/FiO2 ratio [less than or equal to] 300 mmHg. Median age was 80.5 years, and 85.3% had [greater than or equal to] 2 comorbidities. Median exposure time to ruxolitinib was 13 days, median dose intensity was 20 mg/day. Overall survival by day 28 was 94.1%. Cumulative incidence of clinical improvement of [greater than or equal to]2 points in the ordinal scale was 82.4% (95% confidence interval, 71-93). Clinical improvement was not affected by low-flow versus high-flow oxygen support but was less frequent in patients with PaO2/FiO2 < 200 mmHg. The most frequent adverse events were anemia, urinary tract infections, and thrombocytopenia. Improvement of inflammatory cytokine profile and activated lymphocyte subsets was observed at day 14. In this prospective cohort of aged and high-risk comorbidity patients with severe COVID-19, compassionate-use ruxolitinib was safe and was associated with improvement of pulmonary function and discharge home in 85.3%. Controlled clinical trials are necessary to establish efficacy of ruxolitinib in COVID-19.
Author(s): Alessandro M. Vannucchi [sup.1] , Benedetta Sordi [sup.1] , Alessandro Morettini [sup.2] , Carlo Nozzoli [sup.3] , Loredana Poggesi [sup.4] , Filippo Pieralli [sup.5] , Alessandro Bartoloni [sup.6] , [...]