Pronounced benefits of JAK inhibition with baricitinib in COVID-19 pneumonia in obese but not lean subjects
Authors' conclusion
The efficacy of baricitinib in COVID-19 pneumonia is linked to obesity suggesting that immunomodulatory therapy benefit is associated with obesity-associated inflammation.
Study context
- Population
- Patients with severe COVID-19 pneumonia in COV-BARRIER, analysed by body mass index (BMI) (<25, 25–30, >30 kg/m²) and age (<65, ≥65 years)
- Comparison
- Baricitinib vs placebo, by BMI category and age
- Primary endpoint
- All-cause mortality by day 28
- Follow-up
- Day 28
Methodological detailspost hoc analysis, multicentre, double-blind, Cox regression adjusted to age
- Post hoc analysis
- Multicentre
- Double-blind
- Cox regression adjusted to age
Primary result
As reported in the abstract
All-cause mortality by day 28, BMI >25 kg/m²
Baricitinib vs PBOIncidence rate ratio (95% CI)
Age <65 years
0.53(0.32–0.87)
Age ≥65 years
0.66(0.46–0.94)
Further findings
28-day all-cause mortality, BMI >30
HR 0.6 · P < 0.05
| Outcome | Baricitinib | PBO | IRR (95% CI) | |
|---|---|---|---|---|
| All-cause mortality by day 28, BMI <25 kg/m²Age <65 years | 6.6% | 8.1 | 1.89 (0.49–7.28) | |
| All-cause mortality by day 28, BMI <25 kg/m²Age ≥65 years | 0.95 (0.46–1.99) | |||
| 0.10.31310Incidence rate ratio (log scale) |
- All-cause mortality by day 28, BMI <25 kg/m² — No survival advantage with baricitinib, irrespective of age
- p>0.05
Original publication
Pronounced benefits of JAK inhibition with baricitinib in COVID-19 pneumonia in obese but not lean subjects. RMD Open. Published 24 May 2024. doi:10.
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