Baricitinib Treatment of Coronavirus Disease 2019 Is Associated With a Reduction in Secondary Infections

Daniel A Sweeney; Bonifride Tuyishimire; Neera Ahuja; John H Beigel; Tatiana Beresnev; Valeria D Cantos; Jose G Castro; Stuart H Cohen; Kaitlyn Cross; Lori E Dodd; Nathan Erdmann; Monica Fung; Varduhi Ghazaryan; Sarah L George; Kevin A Grimes; Noreen A Hynes; Kathleen G Julian; Sheetal Kandiah; Hannah Jang Kim; Corri B Levine; David A Lindholm; David C Lye; Ryan C Maves; Myoung-Don Oh; Catharine Paules; Rekha R Rapaka; Willam R Short; Kay M Tomashek; Cameron R Wolfe; Andre C Kalil

doi:10.1093/ofid/ofad205

Baricitinib Treatment of Coronavirus Disease 2019 Is Associated With a Reduction in Secondary Infections

Open Forum Infect Dis. 2023 Apr 19;10(5):ofad205. doi: 10.1093/ofid/ofad205. eCollection 2023 May.

Authors

Daniel A Sweeney¹, Bonifride Tuyishimire², Neera Ahuja³, John H Beigel⁴, Tatiana Beresnev⁴, Valeria D Cantos⁵, Jose G Castro⁶, Stuart H Cohen⁷, Kaitlyn Cross², Lori E Dodd⁴, Nathan Erdmann⁸, Monica Fung⁹, Varduhi Ghazaryan⁴, Sarah L George¹⁰, Kevin A Grimes¹¹, Noreen A Hynes¹², Kathleen G Julian¹³, Sheetal Kandiah⁵, Hannah Jang Kim^{14

15}, Corri B Levine¹⁶, David A Lindholm^{17

18}, David C Lye^{19

20

21

22}, Ryan C Maves²³, Myoung-Don Oh²⁴, Catharine Paules¹³, Rekha R Rapaka²⁵, Willam R Short²⁶, Kay M Tomashek⁴, Cameron R Wolfe²⁷, Andre C Kalil²⁸

Affiliations

¹ Department of Medicine, University of California San Diego, La Jolla, CA, USA.
² The Emmes Company, LLC, Rockville, MD, USA.
³ Department of Medicine, Stanford University, Palo Alto, CA, USA.
⁴ National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
⁵ Department of Medicine, Emory University, Atlanta, GA, USA.
⁶ Department of Medicine, University of Miami, Miami, FL, USA.
⁷ Department of Internal Medicine, University of California Davis, Sacramento, CA, USA.
⁸ Department of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
⁹ Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
¹⁰ Department of Medicine, Saint Louis University and St. Louis VA Medical Center, Saint Louis, MO, USA.
¹¹ Department of Medicine, Houston Methodist, Houston, TX, USA.
¹² Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹³ Department of Medicine, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
¹⁴ Community Health Systems Department, University of California San Francisco, San Francisco, CA, USA.
¹⁵ Department of Nursing, Kaiser Permanente National Patient Care Services, Oakland, CA, USA.
¹⁶ Department of Internal Medicine Galveston, University of Texas Medical Branch, TX, USA.
¹⁷ Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
¹⁸ Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Ft Sam Houston, TX, USA.
¹⁹ National Centre for Infectious Diseases, Singapore, Singapore.
²⁰ Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
²¹ Lee Kong Chian School of Medicine, Singapore, Singapore.
²² Yong Loo Lin School of Medicine, Singapore, Singapore.
²³ Departments of Internal Medicine and Anesthesiology, Wake Forest University, Winston-Salem, NC, USA.
²⁴ Department of Internal Medicine, Seoul National University Hospital College of Medicine, Seoul, Korea.
²⁵ Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
²⁶ Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
²⁷ Department of Medicine, Duke University, Durham, NC, USA.
²⁸ Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

Abstract

We performed a secondary analysis of the National Institutes of Health-sponsored Adaptive COVID-19 Treatment Trial (ACTT-2) randomized controlled trial and found that baricitinib was associated with a 50% reduction in secondary infections after controlling for baseline and postrandomization patient characteristics. This finding provides a novel mechanism of benefit for baricitinib and supports the safety profile of this immunomodulator for the treatment of coronavirus disease 2019.

Keywords: COVID-19; baricitinib; secondary infections.

Abstract

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