A clinical trial involving COVID-19 patients hospitalized at UT Health San Antonio and University Health, among roughly 100 sites globally, found that a combination of the drugs baricitinib and remdesivir reduced time to recovery, according to results published Dec. 11 in the New England Journal of Medicine. Six researchers from UT Health San Antonio and University Health are coauthors of the publication because of the San Antonio site's sizable patient enrollment in the trial.
The Adaptive COVID-19 Treatment Trial 2 (ACTT-2), which compared the combination therapy versus remdesivir paired with an inactive placebo in hospitalized COVID-19 patients, was supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
Significantly, patients on high oxygen by nasal canula or receiving breathing assistance with a mask when they were enrolled in the study had a time to recovery of 10 days with combination treatment versus 18 days with remdesivir and placebo.
Investigators also saw a difference in patient survival. The 28-day death rate was 5.1% in the combination therapy group and 7.8% in the remdesivir placebo group.
"We are making progress in the treatment of COVID-19," said principal investigator Thomas Patterson, MD, professor and chief of infectious diseases in the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio. "Remdesivir markedly improved recovery of critically ill patients in the first ACTT study, and baricitinib further helped patients in this second study."
Remdesivir is a direct-acting antiviral drug, whereas baricitinib is an anti-inflammatory medicine.
"I think this combination is good for a couple of reasons," Dr. Patterson said. "Baricitinib, as opposed to other anti-inflammatory drugs, has activity itself against the virus. Second, it is a pretty specific inhibitor of the inflammation."
Baricitinib is approved for the treatment of patients with active rheumatoid arthritis. The U.S. Food and Drug Administration issued an emergency use authorization on Nov. 19, 2020, for baricitinib, in combination with remdesivir, for the treatment of suspected or laboratory-confirmed COVID-19 in hospitalized adults and pediatric patients 2 years of age or older requiring supplemental oxygen, invasive mechanical ventilation or extracorporeal membrane oxygenation.
"We do these clinical trials to accomplish a goal, and that is to save lives," Dr. Patterson said. "At the beginning of the pandemic, we were losing a lot of patients who we are now saving, so we are getting closer to our goal."
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The University of Texas Health Science Center at San Antonio, also known as UT Health San Antonio, is one of the country's leading health sciences universities and is designated as a Hispanic-Serving Institution by the U.S. Department of Education. With missions of teaching, research, patient care and community engagement, its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have graduated more than 37,000 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways "We make lives better®," visit http://www.uthscsa.edu. Stay connected with us on Facebook, Twitter, LinkedIn, Instagram and YouTube. To see how we are battling COVID-19, read inspiring stories on Impact.
About University Health System, now referred to as University Health
University Health System, now referred to as University Health, is San Antonio's only locally owned health system and the only academic medical center in South Texas. Its University Hospital serves as the region's Level I trauma center for adults and children, and is the only area hospital to be state-designated at the highest level for both its Maternity Center and Neonatal Intensive Care Unit. Outpatient care is provided through a comprehensive network of urgent, primary and specialty care centers. For more than 100 years, University Health has been committed to delivering compassionate, culturally competent and high-quality healthcare, based on a strong foundation of outcomes?based research and innovative teaching. Learn more at UniversityHealthSystem.com. Follow us on Twitter and Facebook.
Journal
New England Journal of Medicine