Anti-Inflammatory Treatment of COVID-19 Pneumonia With Tofacitinib Alone or in Combination With Dexamethasone is Safe and Possibly Superior to Dexamethasone as a Single Agent in a Predominantly African American Cohort.

Autor:	Hayek ME; Delta Regional Medical Center, Greenville, MS., Mansour M; Delta Regional Medical Center, Greenville, MS., Ndetan H; Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at Tyler, Tyler, TX., Burkes Q; Delta Regional Medical Center, Greenville, MS., Corkern R; Delta Regional Medical Center, Greenville, MS., Dulli A; Delta Regional Medical Center, Greenville, MS., Hayek R; University of Mississippi Medical School, Jackson, MS., Parvez K; Delta Regional Medical Center, Greenville, MS., Singh S; Delta Regional Medical Center, Greenville, MS.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings. Innovations, quality & outcomes [Mayo Clin Proc Innov Qual Outcomes] 2021 Jun; Vol. 5 (3), pp. 605-613. Date of Electronic Publication: 2021 Mar 27.
DOI:	10.1016/j.mayocpiqo.2021.03.007
Abstrakt:	Objective: To explore the survival benefit of tofacitinib in addition to dexamethasone in hospitalized patients treated for coronavirus disease 2019 (COVID-19)-related pneumonia. Patients and Methods: This is a single-center retrospective observational study. All patients who were hospitalized at Delta Regional Medical Center (a regional hospital in the Mississippi Delta) with a COVID-19 diagnosis and discharged between March 1 and September 30, 2020, are included. The primary outcome was in-hospital mortality in relation to receipt of tofacitinib alone or in addition to dexamethasone (designated as the tofacitinib group), versus dexamethasone alone (designated as the dexamethasone group). Results: Of 269 eligible patients, 138 (51.3%) received tofacitinib uniformly and 131 (48.7%) patients received dexamethasone without tofacitinib. A total of 44 patients expired: 14 (31.8%) in the tofacitinib group and 30 (68.2%) in the dexamethasone group. The proportions of death among the tofacitinib and dexamethasone groups were, respectively, 10.1% and 22.9%. This represents a 70% reduction in odds of dying among the tofacitinib group compared to the dexamethasone group after adjusting for age and clinical parameters captured at hospitalization (adjusted odds ratio: 0.30; 95% CI: 0.12 to 0.76; P =.01). Conclusion: The in-patient treatment of COVID-19 pneumonia has rapidly evolved. The addition of dexamethasone has made a relevant improvement on survival. Other immunomodulators have yet to show an impact. Here we present the potential survival benefit of the Janus kinase-signal transducer and activator of transcription inhibitor tofacitinib on COVID-19 pneumonia. We found that adding tofacitinib-based anti-inflammatory therapy to a treatment regimen including dexamethasone in COVID-19 pneumonia seems to have potential benefit of improving survival when compared to dexamethasone alone. (© 2021 The Authors.)
Databáze:	MEDLINE
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