Comparison of baricitinib and tocilizumab in clinical outcome among hospitalized patients with severe form of COVID-19 – our experiences

Abstract

Introduction/Objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection manifests with an unpredictable clinical course that could rapidly progress, leading to serious and often fatal complications. The identification of effective laboratory biomarkers that could stratify patients at risk of developing severe forms of the disease is imperative to ensure they receive prompt medical treatment. The aim of our study was to compare baricitinib and tocilizumab regarding clinical outcomes in hospitalized patients with severe COVID-19.

Methods A retrospective study included analysis of data from 82 patients of both sexes who were treated with biological immunosuppressive therapy at the Military COVID Hospital, Karaburma. All patients who met the criteria for use according to the guidelines of the national protocol for the treatment of COVID-19, version XIII, had a consultative decision made for the application of biological immunosuppressive therapy. Half were treated with tocilizumab, and the other half with baricitinib.

Results The results of our study show that the mortality rate is lower in the group treated with tocilizumab compared with the group treated with baricitinib: 17.1% vs. 26.8%, but without statistical significance (p = 0.286). Additionally, the use of tocilizumab reduces the need for mechanical ventilation compared with baricitinib: 53.6% vs. 68.3%, without statistical significance (p = 0.454).

Conclusion The results obtained in our study indicate that both drugs are equally clinically effective.

Keywords: COVID-19; clinical outcome; cytokine storm; baricitinib; tocilizumab