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Baricitinib for the Management of SARS-CoV-2-Infected Patients: A Systematic Review and Meta-Analysis of Randomised
Sivananthan Manoharan1, Lee Ying Ying2
1Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Shah Alam, Selangor, Malaysia.
Abstract:
Baricitinib is known to reduce mortality and disease progression in COVID-19 patients; however, the data are inconsistent. Therefore, it needs to be explored to further understand the clinical benefits of this drug in the management of COVID-19 patients. Does baricitinib statistically significantly reduce mortality and disease progression in COVID-19 patients? To answer these questions, three databases known as ScienceDirect, PubMed/MEDLINE, and Scopus and other sources, such as preprint (medRxiv) and reference lists, were thoroughly searched. Four randomised controlled trials (RCTs) were included. Based on the meta-analysis, baricitinib statistically significantly reduced mortality with the risk ratio (RR) of RR = 0.74 [95% CI: 0.58 to 0.94; p = 0.01] and moderately high heterogeneity, where I 2 = 62% and p = 0.05. On the other hand, RR = 0.84 [95% CI: 0.75 to 0.95; p = 0.005] with insignificant heterogeneity of I 2 = 20% and p = 0.28 was found for disease progression. Cochrane risk of bias (RoB) analysis revealed that three out of four articles were ranked as high-quality articles with low RoB. Based on the evidence grading, the overall certainty of evidences was moderate. In conclusion, baricitinib statistically significantly reduced mortality and disease progression in COVID-19 patients when the patients were treated with baricitinib at a dosage of 2 mg or 4 mg for a maximum duration of 14 days.
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