4CPS-108 Biomarkers evolution in patients with SARS-CoV-2 pneumonia treated with baricitinib

• Published in: European journal of hospital pharmacy. Science and practice Vol. 29; no. Suppl 1; pp. A64 - A65
• Main Authors: Escolà Rodríguez, A, Alonso Navarro, R, Albanell Fernández, M, Arranz Pascual, N, Roma Mora, JR, Soy Muner, D, Tuset Creus, M, Soriano Viladomiu, A
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 23.03.2022; BMJ Publishing Group LTD
• Subjects: Biomarkers; Conflicts of interest; Coronaviruses; COVID-19; Lymphocytes; Mortality; Pneumonia; Section 4: Clinical pharmacy services; Severe acute respiratory syndrome coronavirus 2
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2022-eahp.136

Background and importanceA randomised clinical trial has demonstrated that baricitinib reduces the mortality of patients with SARS-CoV-2 that require hospitalisation. However, the evolution of biomarkers that predict the patients’ outcome is not well described.Aim and objectivesTo analyse the evolution of biomarkers in hospitalised adults with SARS-CoV-2 pneumonia treated with baricitinib.Material and methodsWe conducted a retrospective observational study in a tertiary university hospital (760 beds). We included 31 patients positive for SARS-CoV-2 between January and February 2021. All received baricitinib 4 mg daily for ≥5 days (2 mg daily if glomerular filtration <60 mL/min).We evaluated five biomarkers: lymphocytes, C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH) and D-dimer. The results were obtained on the day of admission (D+0) and on days 2 (D+2), 5 (D+5), 7 (D+7) and 10 (D+10) after starting baricitinib.A pharmacist was involved in the multidisciplinary team taking part in COVID-19 protocol drafting, validation of treatments, dose adjustments, interactions, and monitoring of adverse effects.The REDCap database was used for data collection and the G-STAT-2.0.1 for statistical analysis (paired t-test/Holm–Bonferroni correction).ResultsA total of 31 patients were included: 6 women and 25 men. Median age (IQR) was 64 (55;75) years.Main comorbidities were dyslipidaemia (39%), hypertension (35%), pulmonary disease (29%), diabetes (16%) and cardiopathy (16%). During admission, 15 (48%) received corticosteroids and 18 (58%) remdesivir, 7 (23%) needed high-flow oxygen, 5 (16%) required intensive care unit (ICU) admission and 2 (6%) died.Baseline biomarkers, as median (IQR), were: CRP 8.2 (5;11) mg/dL, ferritin 402 (176;794) ng/mL, LDH 280 (237;340) U/L, lymphocytes 0.6 (0.4;0.9) 109/L and D-dimer 500 (300;700) ng/mL.The change in the biomarkers is shown in Figure 1. There was a decrease in CRP which was statistically significant from D+5 (p=0.0144) onwards and an increase in lymphocyte count significant from D+2 (p=0.0148) onwards. LDH, ferritin and D-dimer did not significantly improve. No patient had thromboembolic complications or other adverse reactions associated with treatment.Abstract 4CPS-108 Figure 1Evolution of biomarkers from day 0 (D+0) to day 10 (D+10) after initiation of baricitinib treatmentConclusion and relevancePatients with severe SARS-CoV-2 pneumonia treated with baricitinib showed a significant increase in lymphocyte counts as well as a significant decrease in CRP shortly after baricitinib treatment. This fact, together with the low mortality, and good tolerance supports the use of baricitinib for patients with COVID-19 pneumonia.References and/or acknowledgementsConflict of interestNo conflict of interest