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Baricitinib vs. Tocilizumab in the Management of Severe COVID-19

Patients with severe COVID-19 had statistically equivalent mortality rates but significantly fewer adverse effects with baricitinib compared with tocilizumab, according to a study at 11 Georgia hospitals. The authors conclude, “Our data suggest that baricitinib may be a better choice when treating patients with severe COVID-19, but additional prospective, randomized trials are needed to help clinicians choose the most optimal drug.”

The propensity score-matched, retrospective, observational study included 956 adult patients with severe COVID-19 who received at least 1 dose of either baricitinib or tocilizumab between June and Oct. 2021. Based on a primary outcome of in-hospital mortality and a key secondary outcome of the rate of adverse effects, the study found, “The median age was 57 years, and 53% were of male sex. The median body mass index was 33.5, and more than 94% of the population was unvaccinated. Propensity score matching by baseline characteristics resulted in a total of 582 patients, 291 in each group. There was no difference in mortality between the two groups; however, the occurrence rate of adverse effects was significantly higher in the tocilizumab group compared with baricitinib: secondary infections (32% vs 22%; P <0.01); thrombotic events (24% vs 16%; P <0.01); and acute liver injury (8% vs 3%; P <0.01).”

Source: Critical Care Medicine