Laboratory profiles of patients hospitalized with COVID-19 pneumonia treated with tofacitinib or placebo: a post hoc analysis from the STOP-COVID trial

Einstein (Sao Paulo). 2024 Nov 4:22:eAO0821. doi: 10.31744/einstein_journal/2024AO0821. eCollection 2024.

Abstract

Objective: Tofacitinib, an oral Janus kinase inhibitor, has been tested against a placebo in 289 patients with COVID-19 pneumonia. We analyzed the data from the tofacitinib- and placebo-treated patient cohorts to evaluate the laboratory profiles between baseline and day 7.

Methods: We performed post hoc analyses on the following laboratory tests over time during the first 7 days after randomization: hemoglobin, leukocytes, neutrophils, lymphocytes, platelets, alanine aminotransferase, and aspartate aminotransferase.

Results: Through the first 7 days after randomization, the levels of hemoglobin, white blood cells, neutrophils, and platelet counts were not significantly different between patients treated with tofacitinib or a placebo (all p>0.05). Non-significant differences were observed in aspartate aminotransferase levels over time between treatment groups, whereas alanine aminotransferase levels (U/L) were higher among tofacitinib-treated patients compared to placebo-treated patients (mean ratio, 1.30 [95% confidence interval (95%CI) = 1.14-1.48; p<0.01)].

Conclusion: In patients with COVID-19 pneumonia, the use of tofacitinib compared to placebo did not result in clinically meaningful changes in blood counts or liver enzymes over the first 7 days after randomization.

Registry of clinical trials: NCT04469114.

Plain language summary

In a post hoc analysis of the study of tofacitinib in hospitalized patients with COVID-19 pneumonia (STOP-COVID) trial, Guimaraes et al. evaluated the laboratory safety profile of tofacitinib use during the first 7 days of treatment in patients hospitalized with COVID-19 pneumonia compared with placebo. No clinically meaningful changes were observed in the value of white blood cells, lymphocytes, neutrophils, platelets, hemoglobin, or liver enzymes.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases* / blood
  • COVID-19 / blood
  • COVID-19 Drug Treatment*
  • Double-Blind Method
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Piperidines* / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines* / therapeutic use
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • tofacitinib
  • Pyrimidines
  • Piperidines
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Protein Kinase Inhibitors

Associated data

  • ClinicalTrials.gov/NCT04469114