Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study
OBJECTIVES:. In patients hospitalized with COVID-19 pneumonia, both tocilizumab and baricitinib have been shown to have clinical benefit compared with placebo. To date, there are few data comparing the two treatments, and their relative benefits and harms are unknown. This study aims to evaluate the...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-05-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000702 |
| _version_ | 1811236978465701888 |
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| author | John Roddy, MD Daniel Wells, MSN Katharine Schenck, PA-C Shrihari Santosh, PhD Sadashiv Santosh, MD |
| author_facet | John Roddy, MD Daniel Wells, MSN Katharine Schenck, PA-C Shrihari Santosh, PhD Sadashiv Santosh, MD |
| author_sort | John Roddy, MD |
| collection | DOAJ |
| description | OBJECTIVES:. In patients hospitalized with COVID-19 pneumonia, both tocilizumab and baricitinib have been shown to have clinical benefit compared with placebo. To date, there are few data comparing the two treatments, and their relative benefits and harms are unknown. This study aims to evaluate the effectiveness of tocilizumab versus baricitinib in patients hospitalized with COVID-19 pneumonia and hypoxemia.
DESIGN:. Retrospective cohort study.
SETTING:. Seven inpatient acute-care hospitals in Wisconsin.
PARTICIPANTS:. Patients hospitalized with COVID-19, hypoxemia, and Pao2-to-Fio2 ratio less than or equal to 300 mm Hg, who received either tocilizumab or baricitinib.
INTERVENTIONS:. Electronic chart review.
MEASUREMENTS AND MAIN RESULTS:. Patients were divided into tocilizumab and baricitinib cohorts based on actual medication received. The primary outcome was hospital discharge alive and free from mechanical ventilation within 60 days, assessed by logistic regression. Three hundred eighty-two patients were included: 194 in the tocilizumab cohort and 188 in the baricitinib cohort. Most baseline characteristics in the two cohorts were similar. All patients received dexamethasone. Two patients were lost to follow-up. In the remaining 380 patients, probability of successful discharge in the two cohorts was quantitatively similar in unadjusted, multivariate-adjusted, and propensity score-matched analyses. Hospital length of stay, rates of thromboembolic events, and rates of hospital-acquired infections were all similar in the two cohorts.
CONCLUSIONS:. In patients hospitalized with COVID-19 pneumonia and hypoxemia who receive dexamethasone, treatment with tocilizumab or baricitinib appears to result in similar outcomes. |
| first_indexed | 2024-04-12T12:17:59Z |
| format | Article |
| id | doaj.art-98bab590da8541b9bf4bbf9207d8b020 |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-04-12T12:17:59Z |
| publishDate | 2022-05-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-98bab590da8541b9bf4bbf9207d8b0202022-12-22T03:33:23ZengWolters KluwerCritical Care Explorations2639-80282022-05-0145e070210.1097/CCE.0000000000000702202205000-00010Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort StudyJohn Roddy, MD0Daniel Wells, MSN1Katharine Schenck, PA-C2Shrihari Santosh, PhD3Sadashiv Santosh, MD41 Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.2 Ascension Wisconsin, Glendale, WI.2 Ascension Wisconsin, Glendale, WI.3 University of Colorado at Boulder, Leeds School of Business, Boulder, CO.4 Division of Pulmonary, Critical Care, and Sleep Medicine, Saint Louis University School of Medicine, Saint Louis, MO.OBJECTIVES:. In patients hospitalized with COVID-19 pneumonia, both tocilizumab and baricitinib have been shown to have clinical benefit compared with placebo. To date, there are few data comparing the two treatments, and their relative benefits and harms are unknown. This study aims to evaluate the effectiveness of tocilizumab versus baricitinib in patients hospitalized with COVID-19 pneumonia and hypoxemia. DESIGN:. Retrospective cohort study. SETTING:. Seven inpatient acute-care hospitals in Wisconsin. PARTICIPANTS:. Patients hospitalized with COVID-19, hypoxemia, and Pao2-to-Fio2 ratio less than or equal to 300 mm Hg, who received either tocilizumab or baricitinib. INTERVENTIONS:. Electronic chart review. MEASUREMENTS AND MAIN RESULTS:. Patients were divided into tocilizumab and baricitinib cohorts based on actual medication received. The primary outcome was hospital discharge alive and free from mechanical ventilation within 60 days, assessed by logistic regression. Three hundred eighty-two patients were included: 194 in the tocilizumab cohort and 188 in the baricitinib cohort. Most baseline characteristics in the two cohorts were similar. All patients received dexamethasone. Two patients were lost to follow-up. In the remaining 380 patients, probability of successful discharge in the two cohorts was quantitatively similar in unadjusted, multivariate-adjusted, and propensity score-matched analyses. Hospital length of stay, rates of thromboembolic events, and rates of hospital-acquired infections were all similar in the two cohorts. CONCLUSIONS:. In patients hospitalized with COVID-19 pneumonia and hypoxemia who receive dexamethasone, treatment with tocilizumab or baricitinib appears to result in similar outcomes.http://journals.lww.com/10.1097/CCE.0000000000000702 |
| spellingShingle | John Roddy, MD Daniel Wells, MSN Katharine Schenck, PA-C Shrihari Santosh, PhD Sadashiv Santosh, MD Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study Critical Care Explorations |
| title | Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study |
| title_full | Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study |
| title_fullStr | Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study |
| title_full_unstemmed | Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study |
| title_short | Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study |
| title_sort | tocilizumab versus baricitinib in patients hospitalized with covid 19 pneumonia and hypoxemia a multicenter retrospective cohort study |
| url | http://journals.lww.com/10.1097/CCE.0000000000000702 |
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