Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico.
Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico.
J Infect Dev Ctries. 2022 Jan 31;16(1):63-72. doi: 10.3855/jidc.15126.
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.
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.
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.
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.
严重急性呼吸综合征相关冠状病毒（SARS-CoV-2）感染的特征是病毒期和严重的促炎期。JAK/STAT 通路的抑制可限制中度至重度 COVID-19 的促炎状态。
我们分析了在墨西哥 22 家医院接受鲁索利替尼治疗的 SARS-CoV-2 肺炎患者的观察性队列获得的数据。应用剂量是根据医生的标准来确定的。鲁索利替尼的疗效通过 NIH 在 ACTT1 试验中开发的 8 分序量表来评估。还测量了住院时间、促炎实验室值的变化、死亡率和毒性。
2020 年 3 月至 6 月，墨西哥 22 个地点共报告了 287 例患者；80.8%接受鲁索利替尼 5 mg BID，19.16%接受鲁索利替尼 10 mg BID 加标准治疗。在开始治疗时，223 名患者需要吸氧，59 名需要有创通气。10 mg 组有 53%的患者需要有创通气，而 5 mg 组有 13%的患者需要有创通气。描述了一个统计学上显著的改善，即 8 分序量表上的评分降低了 2 分（基线 5.39±0.93，最终 3.67±2.98，p=0.0001）。有 74 例死亡。6.9%的患者出现严重不良事件。
鲁索利替尼在 COVID-19 患者中似乎是安全的，观察到在 8 分序量表和促炎状态方面的临床益处。必须进行进一步的研究以确保对死亡率的疗效。
