COVID-19 · Immunomodulation in COVID-19
Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19
| Design | Double-blind, randomised, placebo-controlled trial |
|---|---|
| Treatment | Baricitinib plus remdesivir |
| Control | Remdesivir plus placebo |
| Population | 1033 hospitalised adults with COVID-19 |
| Follow-up | 29 days |
| Primary endpoint | Time to recovery |
| Result | Median time to recovery was 7 days (95% CI 6 to 8) with baricitinib plus remdesivir versus 8 days with remdesivir alone. Clinical status improved faster, most markedly among patients receiving high-flow oxygen or non-invasive ventilation at enrolment. |
| Secondary endpoints | Clinical status at day 15, mortality, adverse events |
Baricitinib plus remdesivir was superior to remdesivir alone in reducing recovery time and accelerating improvement in clinical status among patients with Covid-19, notably among those receiving high-flow oxygen or noninvasive ventilation.
The trial authors, in the published abstract
A one-day difference in a soft endpoint, on a background of remdesivir whose own benefit is contested. The subgroup on non-invasive support is where the signal concentrates, consistent with REMAP-CAP IL-6: immunomodulation helps when the disease has become inflammatory.
Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19. N Engl J Med 2021 Mar 4;384(9):795-807.