A trial led by The University of Oxford has shown that Eli Lilly and Incyte’s jointly developed drug, baricitinib, improves survival rates when given to patients hospitalised with severe COVID-19.
The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial testing baricitinib – an anti-inflammatory treatment usually used to treat rheumatoid arthritis – is the biggest study of COVID-19 treatments in the world, involving more than 47,000 participants in the UK.
The benefit of baricitinib was in addition to two other anti-inflammatory treatments – tocilizumab and dexamethasone – which have previously demonstrated to improve survival rates in these patients.
Since March 2020, the RECOVERY trial has tested a variety of potential therapies for patients admitted to hospital with COVID-19. Between February and December 2021, 4,008 patients randomly allocated to usual care alone were compared to 4,148 patients who were randomly allocated to usual care plus the baricitinib treatment.
The trial showed that treatment with baricitinib significantly reduced deaths – 12% of the patients in the baricitinib group died within 28 days compared with 14% of patients in the usual care group – a reduction of 13%. The benefit of baricitinib proved to be consistent regardless of which other COVID-19 treatments the patients were also receiving, including tocilizumab, corticosteroids or remdesivir.
It is hoped the NHS may soon include recommendations for baricitinib based on the latest results. The cost of a 10-day course of the pills is priced at around £250, however, the NHS may be able to agree upon a discount.
Despite COVID-19 vaccines providing protection and cutting infection rates, the trial results are a potential breakthrough treatment for those people who will still catch and go on to become severely ill with the virus. There has also been evidence to suggest some COVID-19 patients on ventilators stand a better chance if they are given baricitinib.
RECOVERY trial joint chief investigator Sir Martin Landray, Professor of medicine and epidemiology, at Oxford Population Health, said: “It is now well established that in people admitted to hospital because of severe COVID-19, an overactive immune response is a key driver of lung damage.
He added: “[The] results not only show that treatment with baricitinib improves the chances of survival for patients with severe COVID-19 but that this benefit is additional to that from other treatments that dampen down the overactive immune response, such as dexamethasone and tocilizumab.
“This opens up the possibility of using combinations of anti-inflammatory drugs to further drive down the risk of death for some of the sickest patients.”