Manoharan Sivananthan, Ying Lee Ying
Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Shah Alam, Selangor, Malaysia.
Asia Metropolitan University, Bandar Baru Seri Alam 81750, Johor Bahru, Johor, Malaysia.
Can J Infect Dis Med Microbiol. 2022 Aug 2;2022:8332819. doi: 10.1155/2022/8332819. eCollection 2022.
Baricitinib is known to reduce mortality and disease progression in COVID-19 patients; however, the data are inconsistent. Therefore, it needs to be explored to further understand the clinical benefits of this drug in the management of COVID-19 patients. Does baricitinib statistically significantly reduce mortality and disease progression in COVID-19 patients? To answer these questions, three databases known as ScienceDirect, PubMed/MEDLINE, and Scopus and other sources, such as preprint (medRxiv) and reference lists, were thoroughly searched. Four randomised controlled trials (RCTs) were included. Based on the meta-analysis, baricitinib statistically significantly reduced mortality with the risk ratio (RR) of RR = 0.74 [95% CI: 0.58 to 0.94; = 0.01] and moderately high heterogeneity, where = 62% and = 0.05. On the other hand, RR = 0.84 [95% CI: 0.75 to 0.95; = 0.005] with insignificant heterogeneity of = 20% and = 0.28 was found for disease progression. Cochrane risk of bias (RoB) analysis revealed that three out of four articles were ranked as high-quality articles with low RoB. Based on the evidence grading, the overall certainty of evidences was moderate. In conclusion, baricitinib statistically significantly reduced mortality and disease progression in COVID-19 patients when the patients were treated with baricitinib at a dosage of 2 mg or 4 mg for a maximum duration of 14 days.
已知巴瑞替尼可降低新冠肺炎患者的死亡率和疾病进展；然而，数据并不一致。因此，需要进一步探索以更好地理解该药物在新冠肺炎患者治疗中的临床益处。巴瑞替尼在统计学上是否能显著降低新冠肺炎患者的死亡率和疾病进展？为回答这些问题，我们全面检索了三个数据库，即ScienceDirect、PubMed/MEDLINE和Scopus，以及其他来源，如预印本（medRxiv）和参考文献列表。共纳入四项随机对照试验（RCT）。基于荟萃分析，巴瑞替尼在统计学上显著降低了死亡率，风险比（RR）为RR = 0.74 [95%置信区间：0.58至0.94；P = 0.01]，且存在中度高度异质性，其中I² = 62%，P = 0.05。另一方面，发现疾病进展的RR = 0.84 [95%置信区间：0.75至0.95；P = 0.005]，异质性不显著，I² = 20%，P = 0.28。Cochrane偏倚风险（RoB）分析显示，四篇文章中有三篇被列为低RoB的高质量文章。基于证据分级，证据的总体确定性为中等。总之，当新冠肺炎患者以2毫克或4毫克的剂量服用巴瑞替尼，最长持续14天时，巴瑞替尼在统计学上显著降低了患者的死亡率和疾病进展。
