Use of baricitinib in treatment of COVID‐19: a systematic review

  1. Ananyan Sampath
  2. Aditya Banerjee
  3. Shubham Atal
  4. Ratinder Jhaj

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Abstract

Objective

To assess the role of baricitinib alone or in combination with other therapies as a treatment for patients with COVID‐19.

Methods

Systematic literature search was conducted in the WHO COVID‐19 coronavirus disease database to find clinical studies on use of baricitinib for treatment of COVID‐19 between December 1, 2019 and September 30, 2021. Two independent set of reviewers identified the eligible studies fulfilling the inclusion criteria, relevant data was extracted and a qualitative synthesis of evidence performed. The risk of bias was evaluated with validated tools.

Results

A total of 267 articles were found to be eligible after primary screening of titles and abstracts. Following assessment of full texts, 19 studies were finally included for this systematic review, out of which 16 are observational, and 3 are interventional studies. Collating the results from these observational and interventional studies, baricitinib used as add‐on to standard therapy, either alone or in combination with other drugs, was found to have favorable outcomes in hospitalized patients with moderate to severe COVID‐19. Furthermore, ongoing trials indicate that the drug is being extensively studied across the world for its safety and efficacy in COVID‐19.

Conclusion

Baricitinib significantly improves clinical outcomes in hospitalized patients with COVID‐19 pneumonia, and further evidence will establish the drug as a standard treatment among such patients.

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  1. Version published to 10.1002/med.21951
  2. ScreenIT

    SciScore for 10.1101/2021.12.26.21268434: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Despite the considerable heterogeneity in terms of study populations, sites, study designs, treatment regimens, significant individual limitations, as well as the differences in summary measures, the evidence available does largely provide a common pattern in favour of utility of the drug in COVID-19, supported by satisfactory safety of treatment. Further studies, particularly the multiple ongoing RCTs, should be able to provide more definitive evidence in all regards. Among the eleven observational studies, including 9 cohort/cross-sectional and two case control studies, most of the results appear to point towards a similar pattern favouring beneficial improvements of key clinical outcomes and/or biochemical or laboratory parameters with baricitinib therapy in moderate to severe COVID-19 hospitalised patients, generally used in addition to standard of care. Observational studies also compared baricitinib to other drugs such as tocilizumab (25), used various doses of baricitinib (20, 31) assessed therapeutic effects of loading dose changes h or combination with other drugs such as tocilizumab (21), LMWHs like enoxaparin (22–26,31) etc., to investigate outcome parameters such as mortality, improvement in oxygen saturation, hospital stay, need for intensification of treatment like ventilatory requirement, virological clearance and inflammatory biochemical markers like CRP. Most of the above permutations of baricitinib interventions and outcomes depicted results favour of barici...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04401579CompletedAdaptive COVID-19 Treatment Trial 2 (ACTT-2)

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.12.26.21268434 on medRxiv