Baricitinib as Treatment Option for Corona Virus Disease-19: a Literature Review

Abstract

Background : Treatment of COVID-19 using IL-6 inhibitors, including Sarilumab or Tocilizumab, significantly decreased mortality risk. Though, Remdesivir therapy gave benefits, morbidity and mortality remained high. Baricitinib, a JAK inhibitor, can inhibit IL-6 activation pathway and has a potential effect of inhibiting disease progression to become severe. Objective : This study aimed to evaluate the use of Baricitinib for COVID-19 patients. Methods : This study was conducted by searching for observational and randomized controlled trial studies through online databases, “PubMed” and “Google Scholar”. Studies included must evaluate Baricitinib effectivity as therapy for hospitalized COVID-19 patients. This study included 11 studies (9 observational and 2 randomized controlled trial). Patients included had moderate-to-severe symptoms of COVID-19. Results : Standard dose of Baricitinib was administered at 4 mg daily dose. Length of therapy was varied between 5-14 days, or up to patients’ discharge. Baricitinib therapy among included studies was administered with intravenous Remdesivir, Steroid, Tocilizumab, or other complement therapies. Mortality rate within 7-day of hospitalization with Baricitinib was 4.4%. Requirement of invasive mechanic ventilation rate after Baricitinib administration was approximately 4%. Laboratory parameters were significantly getting better after Baricitinib administration: IL-6; CRP; ferritin; and D-dimer. Serious adverse events in a randomized controlled trial, occurred more often in placebo treated compared to Baricitinib treated group. Conclusion : Baricitinib as therapy for COVID-19 patients can decrease progression, morbidity, and mortality of the disease. Further studies are needed to evaluate the benefit of Baricitinib as main therapy for COVID-19.