RUXOLITINIB AS A TREATMENT STRATEGY FOR SARS-CoV-2 PNEUMONIA: CLINICAL EXPERIENCE IN A REAL-WORLD SETTING

Abstract

Introduction: 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 cases. Methods: We analysed the data obtained for an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The dose used 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. Results: A total of 287 patients administered ruxolitinib were reported at 22 sites in Mexico from March to June 2020; 80.8% received 5 mg BID and 19.16% received 10 mg BID ruxolitinib. At the beginning of treatment, 223 patients were on oxygen support, 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. There was a statistically significant improvement measured as a reduction by 2 points (initial 5.39 ± 0.93, final 3.67± 2.98, P value = 0.0001) on the 8-point ordinal scale. There were a total of 74 deaths. Serious adverse events were presented in 6.9% of the patients. Conclusion: 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.