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논문 기본 정보

자료유형
학술저널
저자정보
Jorge R. Quiros (St. George's University School of Medicine St. George's Grenada.Broward Health Medical Center Fort) Jennifer Ross-Comptis (Larkin Community Hospital Miami Florida USA.) Donald Hathaway (Lincoln Medical Center Bronx New York USA.) Azza Sarfraz (Larkin Community Hospital Miami Florida USA.) Zouina Sarfraz (Larkin Community Hospital Miami Florida USA.) Zhanna Grigoryan (St. George's University School of Medicine St. George's Grenada.) Kimberly Anne Romero (St. George's University School of Medicine St. George's Grenada.) Abubakar Gapizov (St. George's University School of Medicine St. George's Grenada.) Fortunato S Príncipe-Meneses (Larkin Community Hospital Miami Florida USA.) Manoj Reddy Somagutta (Larkin Community Hospital Miami Florida USA.) Adrian Riva-Moscoso (Larkin Community Hospital Miami Florida USA.) Abdulhusein Kapasi (Larkin Community Hospital Miami Florida USA.)
저널정보
대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제53권 제3호
발행연도
2021.9
수록면
436 - 448 (13page)
DOI
10.3947/ic.2020.0126

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Background: The cause of end-organ damage and acute respiratory distress syndrome (ARDS) in coronavirus disease 2019 (COVID-19) patients is postulated to be connected to the uncontrolled increase of pro-inflammatory cytokines. The upregulation of many cytokines is dependent on signaling through the Janus kinase 1 (JAK-1) and JAK-2 pathways. Ruxolitinib, a JAK-1 and JAK-2 inhibitor, is documented to have potent anti-inflammatory activity by targeting several cytokines and growth factors with proposed efficacy in the cytokine storm observed in severe COVID-19 patients; therefore, this study examines the efficacy and tolerability of ruxolitinib for adult COVID-19 patients. Materials and Methods: This review was conducted using preferred reporting items for aystematic reviews and meta-analyses (PRISMA) methodology. Six reviewers analyzed 1,120 results. Seven studies were selected and validated. A quantitative meta-analysis was further performed to evaluate clinical improvement at day 28, mortality at day 28, and oxygen requirements comparing treatment and standard of care groups. Results: 168 individuals were involved in the studies selected: 122 in cohort studies, 4 in case reports, and 41 in randomized controlled studies. The ruxolitinib group had a higher likelihood of clinical improvement by the 28th day of treatment when assessed with the standard of care (SOC) group (odds ratio [OR]: 1.48; 95% confidence interval [CI]: 0.53 - 4.16; P = 0.45; I2 = 0%). The SOC group was at a higher risk of experiencing serious adverse events (OR: 0.17; 95% CI: 0.03 - 1.13; P = 0.07). Notably the SOC group had a higher likelihood of death (OR: 0.51; 95% CI: 0.11-2.29; P = 0.07; I2 = 0%). Conclusion: Prior studies on ruxolitinib have demonstrated it is able to decrease inflammatory markers. In recent studies on COVID-19, treatment with ruxolitinib decreased the time on mechanical ventilation, hospitalization time, and the need for vasopressor support. Additionally, ruxolitinib showed decreased mortality and demonstrated improvement in lung congestion as evidenced by computerized tomography imaging. These findings warrant further clinical investigation into Ruxolitinib as a potential treatment approach for severe COVID-19.
#COVID-19 #Ruxolitinib #Cytokine storm #ARDS #JAK-STAT

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참고문헌 (23)

참고문헌 신청
World Health Organization (WHO) / Coronavirus disease (COVID-19) weekly epidemiological update and weekly operational update google schola Chen G / 2020 / Clinical and immunological features of severe and moderate coronavirus disease 2019 / J Clin Invest 130:2620~2629 google schola Huang C / 2020 / . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China / Lancet 395:497~506 google schola Luo W / 2020 / Targeting JAK-STAT signaling to control cytokine release syndrome in COVID-19 / Trends Pharmacol Sci 41:531~543 google schola La Rosée F / 2020 / The Janus kinase 1/2 inhibitor ruxolitinib in COVID-19 with severe systemic hyperinflammation / Leukemia 34:1805~1815 google schola

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