Introduction: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19.
Methodology: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician's criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured.
Results: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients.
Conclusions: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.
Keywords: COVID-19; JAK/STAT inhibitors; pneumonia; ruxolitinib.
Copyright (c) 2022 Roberto Ovilla-Martinez, Xochitl Cota-Rangel, Jose De La Pena-Celaya, Mariana Alejandra Alvarado-Zepeda, Alejandro Jimenez Sastre, Humberto Azuara Forcelledo, Bernardino Ordonez Rodriguez, Juan Pulido Broca, Aaron Molina Jaimes, Alejandro Muniz-Carvajal, Maria Magdalena Bahena Garcia, Eduardo Cervera Ceballos, Nidia Paulina Zapata Canto, Jorge Oscar Garcia Mendez, Omar Noel Garcia Jimenez, Jesus Alberto Salas Heredia, Javier Solis Soto, Ruben Alberto Villalobos Mendez, Gregorio Ignacio Ibarra, Cindy Ledesma de la Cruz, Nora Araujo Martinez, Jessi Juarez Lara, Cecilio Omar Ceballos Zuniga, Felipe Vicente Villasenor Perez, Jose Carlos Herrera Garcia, Patricia Nuche Salazar, Alfredo Dominguez Paregrina, Bertha Arizpe Bravo, Gabriela Enciso Figueroa, Teresita Trujillo, Adriana Miguel Alvarez, Diego de Jesus Garcia Gallegos, Alejandro Ortiz Arroyo, Claudia Ivette Solorzano Soto, Hiram Javier Jaramillo Ramirez, Ibis De la Cruz Hernandez, Sergio De Gante Martinez, Guadalupe Esmeralda Montesinos Gomez, Silvia Martinez Velasco, Roberto Garcia Graullera, Miguel Angel Vazquez Lopez, Victor Itai Urbalejo Ceniceros, Yolanda Lugo Garcia, Ana Itamar Gonzalez Avila, Jorge Duque Rodriguez, Rodolfo Ruiz Lujan, Violeta I Rodriguez Rivera, Lucio Soberanes Ramirez, Pamela Elena Baez-Islas.