MONDAY, Feb. 26, 2024 (HealthDay News) — The Adaptive COVID-19 Treatment Trial (ACTT) risk profile identifies hospitalized COVID-19 patients who benefit most from baricitinib treatment, according to a study published online Feb. 27 in the Annals of Internal Medicine.

Noting that the ACTT risk profile previously demonstrated that hospitalized patients in the high-risk quartile benefit most from remdesivir, Catharine I. Paules, M.D., from the Penn State Health Milton S. Hershey Medical Center, and colleagues examined potential baricitinib-related treatment effects by risk quartile in a post hoc analysis of the ACTT-2 trial, conducted in 999 adults hospitalized with COVID-19 at 67 trial sites in eight countries. Participants received baricitinib plus remdesivir or placebo plus remdesivir.

The researchers found that baricitinib plus remdesivir was associated with a reduced risk for death, reduced progression to invasive mechanical ventilation or death, and improved recovery rate compared with placebo plus remdesivir in the high-risk quartile (hazard ratios, 0.38, 0.57, and 1.53, respectively). Compared with control participants, those receiving baricitinib plus remdesivir had significantly larger increases in absolute lymphocyte count and significantly larger decreases in absolute neutrophil count after five days, with the largest effects seen in the high-risk quartile.

“To our knowledge, no other clinical trials have assessed clinical benefit from an immunomodulator with relation to dynamics in hematologic parameters, and these data suggest the relevance of these measurements in predicting treatment response,” the authors write.

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