Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial and updated meta-analysis

Therapeutic advances in COVID-19

“…In the largest RCT of baricitinib to date, the RECOVERY group randomly assigned 8,156 hospitalized adults to receive baricitinib 4 mg daily until either 10 days or hospital discharge, versus usual care. Patients who received baricitinib had lower 28-day mortality than those receiving usual care (age-adjusted RR 0.87, 95% CI 0.77–0.99) 25 . Baricitinib was approved by the FDA in May 2022 and is currently under review by the EMA (Table 1 ).…”

Assessment of Admission COVID-19 Associated Hyperinflammation Syndrome Score in Critically-Ill COVID-19 Patients

“…RECOVERY investigaters have also performed a randomized-controlled trial on efficacy of baracitinib, a Janus kinase (JAK) 1–2 inhibitor. 12 At randomization, 95% of patients were receiving corticosteroid therapy and 23% were receiving tocilizumab and baracitinib led 13% reduction in mortality in hospitalized COVID-19 patients.…”

“…However; different results for immunomodulatory treatments have been reported. 8 – 12 Various studies have demonstrated that the determination of hyperinflammation and its degree may have a pivotal role in order to predict prognosis and decide on immunomodulatory therapy early in the intensive care unit (ICU). 7 , 13 , 14 …”

Experiences of the Data Monitoring Committee for the RECOVERY trial, a large-scale adaptive platform randomised trial of treatments for patients hospitalised with COVID-19

“…During the first 2 years of the trial (March 2020 to February 2022), RECOVERY evaluated 14 different treatments in adults, leading to 10 publications to date [ 4 – 13 ]. Below, we summarise the decisions around four of those treatments (hydroxychloroquine, dexamethasone, casirivimab + imdevimab, and tocilizumab) (further information on these and the other treatments assessed are provided in the Additional file 1 ).…”