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COVID-19 (RECOVERY) で入院した患者のバリシチニブ:ランダム化,制御,オープンラベル,プラットフォーム試験と更新されたメタ解析

Lancet +

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2022年7月31日

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2022年7月31日

PubMedで要約を見る

まとめ

この要約は機械生成です。

ジャヌスキナーゼ (JAK) 阻害剤であるバリシチニブは,入院したCOVID-19患者の死亡率を大幅に低下させた. RECOVERY試験とメタアナリシスのこの発見は,JAK阻害剤治療による死亡率の5分の1の減少を示唆しています.

科学分野

  • 免疫学
  • ウイルス学
  • 臨床医学

背景

  • バリシチニブは,入院したCOVID-19患者の治療のために評価されたジャヌスキナーゼ (JAK) 1-2阻害剤です.
  • この研究は,英国の COVID-19 治療のランダム化評価 (RECOVERY) プラットフォーム試験の中で実施されました.

研究 の 目的

  • 入院中のCOVID-19患者の死亡率を低減するバリシチニブの有効性を評価する.
  • バリシチニブと通常の治療の有効性を,通常の治療のみと比較する.

主な方法

  • ランダム化され,制御され,オープンラベルのプラットフォーム試験 (RECOVERY) で,COVID-19で入院した患者が対象となった.
  • 患者は通常の治療法または通常の治療法とバリシチニブ (10日間1日4mg) に割り当てられました.
  • 主なアウトカムは28日間の死亡率で,前回のJAK阻害剤試験を含むメタ解析で分析された.

主要な成果

  • バリシチニブを投与すると,28日間の死亡率が13%減少した (率比0. 87; p=0. 028).
  • 9件の試験 (11, 888人の患者) のメタ解析では,JAK阻害剤は死亡率を約20%低下させた (率比0. 80; p< 0. 0001).
  • COVID-19以外の死亡,感染,または血栓性イベントの有意な増加は観察されなかった.

結論

  • バリシチニブは,入院したCOVID-19患者の死亡率を著しく低下させていますが,その効果は以前に示唆されたものより少ないのです.
  • ランダム化された証拠は,JAK阻害剤,主にバリシチニブは,COVID-19による死亡率を約5分の1減少させることを示しています.

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