Compassionate use of ruxolitinib in patients with SARS‐Cov‐2 infection not on mechanical ventilation: Short‐term effects on inflammation and ventilation

• DOI: 10.1111/cts.12971
• Publication Date: 2021-01-07T05:43:03Z
• Authors: Andrea Mortara; Simone Mazzetti; Davide Margonato; Pietro Delfino; Chiara Bersano; Francesco Catagnano; Marinella Lauriola; Paolo Grosso; Gianluca Perseghin; Giovanbattista Ip...
• Keywords: Ruxolitinib

Ruxolitinib is an anti-inflammatory drug that inhibits the Janus kinase-signal transducer (JAK-STAT) pathway on surface of immune cells. The potential targeting this using JAK inhibitors a promising approach in patients affected by coronavirus disease 2019 (COVID-19). was provided as compassionate use consecutively admitted to our institution for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection. Inclusion criteria were oxygen saturation less than or equal 92%, signs interstitial pneumonia, and no need mechanical ventilation. Patients received 5 mg b.i.d. ruxolitinib 15 days, data collected at baseline days 4, 7, during treatment. Two main targets identified, C-reactive protein (CRP) PaO2 /FiO2 ratio. In 31 who ruxolitinib, symptoms improved (dyspnea scale) day 7 25 (80.6%); CRP decreased progressively from (79.1 ± 73.4 mg/dl) (18.6 33.2, p = 0.022). parallel with CRP, PO2/FiO2 ratio increased 3 steps 183 95 361 144 mmHg (p < 0.001). those reduction polymerase chain reaction 80%, delta increase significantly more pronounced (129 118 vs. 45 35 mmHg, 0.02). No adverse side effects recorded hospitalized COVID-19, compassionate-use determined significant biomarkers inflammation, which associated effective ventilation reduced support. Data reinforces hypothesis hyperinflammation state, may be prognostic benefit SARS-CoV-2 Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON TOPIC? Some evidence suggest (COVID-19) present exuberant inflammatory response represented massive production type I interferons different pro-inflammatory cytokines. Nonetheless, present, there are proven therapeutic agents particular antiviral, reproducible positive clinical response. QUESTION DID THIS STUDY ADDRESS? Targeted management pathways appears strategy against due its established broad fast effect, candidate worthy focused investigations field. DOES ADD TO OUR KNOWLEDGE? rapidly reduces systemic accompanies disease, thereby improving function This effect contribute avoid progression invasive HOW MIGHT CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE? contributes reinforcement it crucial counteract early particularly lungs, induced COVID-19