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Does baricitinib reduce mortality and disease progression in SARS-CoV-2 virus infected patients? A systematic review and meta analysis - 23/09/22

Doi : 10.1016/j.rmed.2022.106986 
Sivananthan Manoharan a, , Lee Ying Ying b
a 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 
b Asia Metropolitan University, Bandar Baru Seri Alam, 81750, Johor Bahru, Johor, Malaysia 

Corresponding author.

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Abstract

Background

There are conflicting reports on the results of several of the latest clinical trials related to the use of baricitinib in the management of COVID-19 patients. The aim of the current systematic review and meta-analysis was to evaluate the efficacy of baricitinib in COVID-19 patients.

Methods

Databases like ScienceDirect, PubMed/Medline, Publons, Google Scholar and other sources like ClinicalTrials.gov, Cochrane, medRxiv, Research Square and reference lists were thoroughly searched.

Results

Fifteen (15) articles which met the inclusion criteria were qualitatively and quantitatively analysed. Based on Cochrane and Newcastle-Ottawa Scale (NOS) risk of bias (RoB) analyses, 14/15 articles are grouped as high-quality. Meta-analyses revealed that randomised control trials (RCTs) and non-randomised control trials (nRCTs) statistically significantly reduced the mortality rate in COVID-19 patients, with a risk ratio (RR) in the fixed-effect model was RR = 0.64 [95% CI: 0.51 to 0.79; p < 0.0001] and RR = 0.58 [95% CI: 0.45 to 0.73; p < 0.00001], respectively, with insignificant heterogeneity and no publication bias found. For block/reduce disease progression (BDP), baricitinib did not statistically significantly reduce disease progression for RCTs. The RR in the random effect model was RR = 0.80 [95% CI: 0.58 to 1.10: p = 0.17], with significant heterogeneity, where I2 was 60%. On the other hand, baricitinib statistically significantly reduced disease progression in nRCTs, as the RR of the fixed effect model was RR = 0.54 [95% CI: 0.37 to 0.78; p = 0.001] with insignificant heterogeneity.

Conclusion

The current meta-analyses revealed that baricitinib statistically significantly reduced mortality rate and disease progression in COVID-19 patients.

Prospero registration number

CRD42021281556

El texto completo de este artículo está disponible en PDF.

Highlights

Baricitinib statically reduced mortality rate in Covid-19 patients.
Baricitinib statically reduced disease progression in Covid-19 patients.
Based on risk of bias analysis, 14/15 articles are grouped as high-quality studies.

El texto completo de este artículo está disponible en PDF.

Keywords : Baricitinib, Disease progression, Mortality, Meta-analysis, Systematic review, COVID-19


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Vol 202

Artículo 106986- octobre 2022 Regresar al número
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