Portal de Periódicos da CAPES

Compassionate use of JAK1/2 inhibitor ruxolitinib for severe COVID-19: a prospective observational study

2020; Springer Nature; Volume: 35; Issue: 4 Linguagem: Inglês

10.1038/s41375-020-01018-y

1476-5551

Alessandro M. Vannucchi, Benedetta Sordi, A Morettini, Carlo Nozzoli, Loredana Poggesi, Filippo Pieralli, Alessandro Bartoloni, Alessandro Atanasio, Filippo Miselli, Chiara Paoli, Giuseppe Gaetano Loscocco, Andrea Fanelli, Ombretta Para, Andrea Berni, Irene Tassinari, Lorenzo Zammarchi, Laura Maggi, Alessio Mazzoni, Valentina Rita Scotti, Giorgia Falchetti, Danilo Malandrino, Fabio Luise, Giovanni Millotti, Sara Bencini, Manuela Capone, Marie Pierre Piccinni, Francesco Annunziato, Paola Guglielmelli, Francesco Mannelli, Giacomo Coltro, Duccio Fantoni, Miriam Borella, Enrica Ravenda, Benedetta Peruzzi, Roberto Caporale, Lorenzo Cosmi, Francesco Liotta, Letizia Lombardelli, Federica Logiodice, Anna Vanni, Lorenzo Salvati, Chiara Lazzeri, Manuela Bonizzoli, Adriano Peris, Giovanni Cianchi, Alberto Bosi, Michela Pucatti, Paolo Fontanari, Silvia Benemei, Marco Matucci‐Cerinic, Lucia Turco,

Inflammasome and immune disorders

Abstract Overwhelming inflammatory reactions contribute to respiratory distress in patients with COVID-19. Ruxolitinib is a JAK1/JAK2 inhibitor with potent anti-inflammatory properties. We report on a prospective, observational study in 34 patients with COVID-19 who received ruxolitinib on a compassionate-use protocol. Patients had severe pulmonary disease defined by pulmonary infiltrates on imaging and an oxygen saturation ≤ 93% in air and/or PaO2/FiO2 ratio ≤ 300 mmHg. Median age was 80.5 years, and 85.3% had ≥ 2 comorbidities. Median exposure time to ruxolitinib was 13 days, median dose intensity was 20 mg/day. Overall survival by day 28 was 94.1%. Cumulative incidence of clinical improvement of ≥2 points in the ordinal scale was 82.4% (95% confidence interval, 71–93). Clinical improvement was not affected by low-flow versus high-flow oxygen support but was less frequent in patients with PaO2/FiO2 < 200 mmHg. The most frequent adverse events were anemia, urinary tract infections, and thrombocytopenia. Improvement of inflammatory cytokine profile and activated lymphocyte subsets was observed at day 14. In this prospective cohort of aged and high-risk comorbidity patients with severe COVID-19, compassionate-use ruxolitinib was safe and was associated with improvement of pulmonary function and discharge home in 85.3%. Controlled clinical trials are necessary to establish efficacy of ruxolitinib in COVID-19.