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MEDTECH Understanding Baricitinib’s Role in High-Risk COVID-19 Patients
This study explores the application of the ACTT risk profile to the ACTT-2 cohort, evaluating the efficacy of baricitinib in conjunction with remdesivir for treating high-risk hospitalized COVID-19 patients. By focusing on a specific subgroup identified by the ACTT risk profile, the research provides valuable insights into personalized treatment approaches that can enhance patient outcomes in severe COVID-19 cases.
Study Design:
- Trial Design: Post hoc analysis of the ACTT-2 trial, a randomized, double-blind, placebo-controlled study.
- Participants: 999 adults hospitalized with COVID-19, predominantly from the US (85% of participants).
- Interventions: Comparison between baricitinib+remdesivir and placebo+remdesivir.
- Measurements: Evaluated mortality, progression to invasive mechanical ventilation or death, recovery within 28 days, and changes in ALC, ANC, and platelet counts.
Key Findings:
- In the high-risk quartile, baricitinib+remdesivir significantly reduced the risk of death and progression to invasive mechanical ventilation or death, while improving recovery rates compared to placebo+remdesivir.
- Significant changes in ALC and ANC were observed, indicating a potential mechanism where the immunomodulator baricitinib could mitigate severe COVID-19 impacts.
- These effects were most pronounced in patients within the high-risk quartile, suggesting the ACTT risk profile’s effectiveness in identifying patients who would benefit most from the treatment.
HCN Medical Memo
The ACTT risk profile effectively pinpoints hospitalized COVID-19 patients who derive significant benefit from baricitinib, indicating its utility in identifying patients responsive to combined immunomodulatory and antiviral treatments. Alterations in ALC and ANC levels propose a mechanism by which baricitinib may mitigate the severity of COVID-19.
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