Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting.

Autor:	Ovilla-Martinez R; Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico., Cota-Rangel X; Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico., De La Peña-Celaya J; Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico., Alvarado-Zepeda MA; Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico., Jiménez Sastré A; Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico., Azuara Forcelledo H; Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico., Ordoñez Rodriguez B; Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico., Pulido Broca J; Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico., Molina Jaimes A; Infectology, ISSSTE Hospital Regional Tipo B de Alta Especialidad Bicentenario de la Independencia, Tultitlan de Mariano Escobedo, Mexico., Muñiz-Carvajal A; Internal Medicine, Hospital General De Cancún 'Jesús Kumate Rodriguez', Cancun, Quintana Roo, Mexico., Bahena García MM; Hematology, Hospital Central Sur de Alta Especialidad PEMEX, Mexico City, Mexico., Cervera Ceballos E; Hematology, Medica Sur, Mexico City, Mexico., Zapata Canto NP; Hematology, Medica Sur, Mexico City, Mexico., García Mendez JO; Hematology, Medica Sur, Mexico City, Mexico., García Jímenez ON; Internal Medicine, Hospital General Regional No 66 IMSS, Ciudad Juarez, Chihuahua, Mexico., Salas Heredia JA; Intensive Care, Hospital Star Medica Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico., Solis Soto J; Intensive Care, Hospital Star Medica Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico., Villalobos Mendez RA; Intensive Care, Hospital Regional de PEMEX Salamanca, Salamanca, Guanajuato, Mexico., Ignacio Ibarra G; Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico., Ledesma de la Cruz C; Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico., Araujo Martinez N; Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico., Juárez Lara J; Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico., Ceballos Zuñiga CO; Pneumology, Hospital de la Familia, Mexicali, Baja California, Mexico., Villaseñor Pérez FV; Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico., Herrera Garcia JC; Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico., Nuche Salazar P; Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico., Dominguez Paregrina A; Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico., Arizpe Bravo B; Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico., Enciso Figueroa G; Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico., Trujillo T; Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico., Miguel Álvarez A; Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico., García Gallegos DJ; Intensive Care, Hospital General de Zona 10 IMSS, Manzanillo, Colima, Mexico., Ortiz Arroyo A; Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico., Solorzano Soto CI; Intensive Care, Hospital General de Zona 18 IMSS, Playa del Carmen, Quintana Roo, Mexico., Jaramillo Ramírez HJ; Internal Medicine, Hospital General de Mexicali, Mexicali, Baja California, Mexico., De la Cruz Hernández I; Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico., De Gante Martínez S; Internal Medicine, Hospital Angeles Ciudad Juárez, Ciudad Juarez, Chihuahua, Mexico., Montesinos Gómez GE; Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico., Martínez Velasco S; Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico., García Graullera R; Internal Medicine, Hospital General de Zona 3 IMSS, Cancun, Quintana Roo, Mexico., Vázquez López MA; Internal Medicine, Hospital General de Zona 2 IMSS, Tuxtla Gutierrez, Chiapas, Mexico., Urbalejo Ceniceros VI; Hematology, Instituto Nacional de Cancerología, Mexico City, Mexico., Lugo García Y; Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico., González Ávila AI; Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico., Duque Rodriguez J; Hematology, Hospital Ángeles Chihuahua, Chihuahua, Chihuahua, Mexico., Ruiz Luján R; Internal Medicine, Hospital General de Mexicali, Mexicali, Baja California, Mexico., Rodríguez Rivera VI; Gastroenterology, Gastroclinic, Torreon, Coahuila, Mexico., Soberanes Ramírez L; Intensive Care, Hospital General Agustín O' Horan, Merida, Quintana Roo, Mexico., Baez-Islas PE; Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico. drabaez.hematologia@gmail.com.
Jazyk:	angličtina
Zdroj:	Journal of infection in developing countries [J Infect Dev Ctries] 2022 Jan 31; Vol. 16 (1), pp. 63-72. Date of Electronic Publication: 2022 Jan 31.
DOI:	10.3855/jidc.15126
Abstrakt:	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. Methodology: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose 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 were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. Conclusions: 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. Competing Interests: No Conflict of Interest is declared (Copyright (c) 2022 Roberto Ovilla-Martinez, Xochitl Cota-Rangel, Jose De La Pena-Celaya, Mariana Alejandra Alvarado-Zepeda, Alejandro Jimenez Sastre, Humberto Azuara Forcelledo, Bernardino Ordonez Rodriguez, Juan Pulido Broca, Aaron Molina Jaimes, Alejandro Muniz-Carvajal, Maria Magdalena Bahena Garcia, Eduardo Cervera Ceballos, Nidia Paulina Zapata Canto, Jorge Oscar Garcia Mendez, Omar Noel Garcia Jimenez, Jesus Alberto Salas Heredia, Javier Solis Soto, Ruben Alberto Villalobos Mendez, Gregorio Ignacio Ibarra, Cindy Ledesma de la Cruz, Nora Araujo Martinez, Jessi Juarez Lara, Cecilio Omar Ceballos Zuniga, Felipe Vicente Villasenor Perez, Jose Carlos Herrera Garcia, Patricia Nuche Salazar, Alfredo Dominguez Paregrina, Bertha Arizpe Bravo, Gabriela Enciso Figueroa, Teresita Trujillo, Adriana Miguel Alvarez, Diego de Jesus Garcia Gallegos, Alejandro Ortiz Arroyo, Claudia Ivette Solorzano Soto, Hiram Javier Jaramillo Ramirez, Ibis De la Cruz Hernandez, Sergio De Gante Martinez, Guadalupe Esmeralda Montesinos Gomez, Silvia Martinez Velasco, Roberto Garcia Graullera, Miguel Angel Vazquez Lopez, Victor Itai Urbalejo Ceniceros, Yolanda Lugo Garcia, Ana Itamar Gonzalez Avila, Jorge Duque Rodriguez, Rodolfo Ruiz Lujan, Violeta I Rodriguez Rivera, Lucio Soberanes Ramirez, Pamela Elena Baez-Islas.)
Databáze:	MEDLINE
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