Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial and updated meta-analysis
The Lancet, Volume 400, No. 10349, Year 2022
Notification
URL copied to clipboard!
Description
Background: We aimed to evaluate the use of baricitinib, a Janus kinase (JAK) 1–2 inhibitor, for the treatment of patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple possible treatments in patients hospitalised with COVID-19 in the UK. Eligible and consenting patients were randomly allocated (1:1) to either usual standard of care alone (usual care group) or usual care plus baricitinib 4 mg once daily by mouth for 10 days or until discharge if sooner (baricitinib group). The primary outcome was 28-day mortality assessed in the intention-to-treat population. A meta-analysis was done, which included the results from the RECOVERY trial and all previous randomised controlled trials of baricitinib or other JAK inhibitor in patients hospitalised with COVID-19. The RECOVERY trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936) and is ongoing. Findings: Between Feb 2 and Dec 29, 2021, from 10 852 enrolled, 8156 patients were randomly allocated to receive usual care plus baricitinib versus usual care alone. At randomisation, 95% of patients were receiving corticosteroids and 23% were receiving tocilizumab (with planned use within the next 24 h recorded for a further 9%). Overall, 514 (12%) of 4148 patients allocated to baricitinib versus 546 (14%) of 4008 patients allocated to usual care died within 28 days (age-adjusted rate ratio 0·87; 95% CI 0·77–0·99; p=0·028). This 13% proportional reduction in mortality was somewhat smaller than that seen in a meta-analysis of eight previous trials of a JAK inhibitor (involving 3732 patients and 425 deaths), in which allocation to a JAK inhibitor was associated with a 43% proportional reduction in mortality (rate ratio 0·57; 95% CI 0·45–0·72). Including the results from RECOVERY in an updated meta-analysis of all nine completed trials (involving 11 888 randomly assigned patients and 1485 deaths) allocation to baricitinib or another JAK inhibitor was associated with a 20% proportional reduction in mortality (rate ratio 0·80; 95% CI 0·72–0·89; p<0·0001). In RECOVERY, there was no significant excess in death or infection due to non-COVID-19 causes and no significant excess of thrombosis, or other safety outcomes. Interpretation: In patients hospitalised with COVID-19, baricitinib significantly reduced the risk of death but the size of benefit was somewhat smaller than that suggested by previous trials. The total randomised evidence to date suggests that JAK inhibitors (chiefly baricitinib) reduce mortality in patients hospitalised for COVID-19 by about one-fifth. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Authors & Co-Authors
Abbas, Ali
Unknown Affiliation
Abbass, Hakam
Unknown Affiliation
Abdelaziz, Ammar M.Y.
Unknown Affiliation
Abdul-Kadir, Rezan
Unknown Affiliation
Abousamra, Ahmed O.S.
Unknown Affiliation
Acquah, Rebecca Ruth
Unknown Affiliation
Adam, Matthew
Unknown Affiliation
Adams, Katherine
Unknown Affiliation
Agbeko, Rachel Sarah
Unknown Affiliation
Ahmad, Syed Masroor
Unknown Affiliation
Ahmed, Afshan
Unknown Affiliation
Ahmed, Khalid E.
Unknown Affiliation
Ahmed, Muhammad S.
Unknown Affiliation
Ahmed, Osama Abdelhakim Aly
Unknown Affiliation
Akhtar, Nasim
Unknown Affiliation
Akram, Mohammed
Unknown Affiliation
Al-Abadi, Eslam
Unknown Affiliation
Alexander, Alison
Unknown Affiliation
Alexander, John H.P.
Unknown Affiliation
Alghazawi, Laith Omar Khalaf
Unknown Affiliation
Ali, Mohamed Omer
Unknown Affiliation
Ali, Mohammad Rizwan
Unknown Affiliation
Ali, Syed Danish
Unknown Affiliation
Allen, Sam H.
Unknown Affiliation
Alli, Abiola R.
Unknown Affiliation
Allsup, David J.
Unknown Affiliation
Al-Shahi Salman, Rustam
Unknown Affiliation
Anderson, Laura N.
Unknown Affiliation
Aribike, Oluwatoyin
Unknown Affiliation
Ashraf, Muhammad Zubair
Unknown Affiliation
Aujayeb, Avinash
Unknown Affiliation
Babiker, Babiker Ahmed
Unknown Affiliation
Baillie, John Kenneth
Unknown Affiliation
Baird, Yolanda
Unknown Affiliation
Bakerly, Nawar Diar
Unknown Affiliation
Balasubramaniam, Madhu Shankar
Unknown Affiliation
Bamford, A. R.J.
Unknown Affiliation
Bandi, Srini
Unknown Affiliation
Barlow, Gavin D.
Unknown Affiliation
Barnacle, James R.
Unknown Affiliation
Barnett-Vanes, Ashton
Unknown Affiliation
Barr, David Adam
Unknown Affiliation
Basnyat, Buddha
Unknown Affiliation
Bassford, Christopher R.
Unknown Affiliation
Bastola, Anup
Unknown Affiliation
Bayes, Hannah Kelly
Unknown Affiliation
Bazaz, Rohit
Unknown Affiliation
Bell, Louise V.
Unknown Affiliation
Bernatoniene, Jolanta
Unknown Affiliation
Berriman, Thomas
Unknown Affiliation
Beynon, Fenella
Unknown Affiliation
Bhagani, Sanjay R.
Unknown Affiliation
Bibi, Fatima
Unknown Affiliation
Bicanic, Tihana A.
Unknown Affiliation
Bikov, Andras
Unknown Affiliation
Bisnauthsing, Karen N.
Unknown Affiliation
Black, Mairead E.
Unknown Affiliation
Blazeby, Jane M.
Unknown Affiliation
Blencowe, Natalie S.
Unknown Affiliation
Boffito, Marta A.
Unknown Affiliation
Bokhandi, Sumit S.
Unknown Affiliation
Bolger, Clare
Unknown Affiliation
Bousfield, Rachel
Unknown Affiliation
Boyles, Louise
Unknown Affiliation
Brightling, Christopher Edward
Unknown Affiliation
Brown, Louise Clare
Unknown Affiliation
Brown, Nicola
Unknown Affiliation
Brown, Robert Clark
Unknown Affiliation
Brown, Steven Ross
Unknown Affiliation
Brown, Tom
Unknown Affiliation
Brunskill, N. J.
Unknown Affiliation
Buch, Maya Hema
Unknown Affiliation
Buckland, Matthew S.
Unknown Affiliation
Burden, Christy A.
Unknown Affiliation
Burden, Tom G.
Unknown Affiliation
Burhan, Hassan
Unknown Affiliation
Burke, Kerry A.
Unknown Affiliation
Statistics
Citations: 104
Authors: 77
Identifiers
Doi:
10.1016/S0140-6736(22)01109-6
ISSN:
01406736
Research Areas
Covid
Health System And Policy
Study Design
Randomised Control Trial
Cross Sectional Study
Study Approach
Systematic review