There is no specific antiviral treatment recommended for COVID-19, and no vaccine is currently available. Baricitinib, an anti-Janus kinase inhibitor (anti-JAK) acting against JAK1 and JAK2. The drug was found capable to reduce or interrupt the passage of the virus into target cells, and to inhibit the JAK1- and JAK2-mediated cytokine release. The drug was licensed for the treatment of rheumatoid arthritis at the daily dose of 4 mg/orally, with excellent results in terms of clinical response and a good safety profile. Since baricitinib does not interact with antivirals due to its prevalent renal elimination, it may be used in combination.The evidence on the advantageous action of baricitinib on viral entry and cytokine outbreak constituted the rationale to perform a trial on patients with mild to moderate COVID-19 infection receiving baricitinib combined with antiviral therapy.
Study design. Interventional, open-label, 2-week, prospective trial of a cohort of patients
with mild to moderate COVID-19 infection.
Objectives. Primary. To assess the efficacy of baricitinib combined with antiviral therapy in
patients with COVID-19-related mild and moderate disease in terms of reduction of the
percentage of subjects requiring ICU admission.
Secondary objectives. To describe the clinical findings in a cohort of symptomatic
COVID-19-infected subjects; to investigate the role of CRP, IL-6, and TNFα levels as
predictor of progression to ARDS; to assess the type and incidence of adverse events (AEs).
Drug: Baricitinib
Baricitinib 4 mg/day/orally combined to antiviral therapy ritonavir for 2 weeks. Baricitinib tablets 4 mg were administered in the morning.
Other Name: Lopinavir/Ritonavir tablets 250 mg/bid
Inclusion Criteria:
- All consecutive patients with mild to moderate COVID-19 infection
- Age >18 years,
- Clinical diagnosis of COVID19 infection
- Patients should present fever, cough and myalgia and weakness and radiological
findings of pneumonia.
- All patients should be willing and able to provide written informed consent prior to
performing study procedures.
Exclusion Criteria:
- Age less than 18
- History of thrombophlebitis.
- Patient with latent tuberculosis infection (Quantiferon test).
- Pregnancy and lactation.
Fabrizio Cantini
Prato, Tuscany, Italy
Investigator: Fabrizio Cantini
Contact: +39 3408075607
fbrzcantini@gmail.com
Fabrizio Cantini, MD
+393408075607
fbrzcantini@gmail.com
Laura Niccoli, MD
+39 3339849690
lniccoli64@gmail.com
Fabrizio Cantini, MD, Study Director
Hospital of Prato, Italy