Abstract
This non-randomized controlled study aimed to assess the efficacy of
tofacitinib in reducing the risk of invasive mechanical ventilation or
death in patients with Coronavirus Disease 2019 (COVID-19). Patients
with COVID-19 associated with reduced oxygen saturation, increased
C-reactive protein (≥50 mg/L), and/or persisting fever were recruited.
Tofacitinib was administered in addition to standard of care therapy.
Study outcomes were evaluated separately in the groups of patients with
oxygen saturation at rest ≤93% and >93%. Hazard ratios
(HR) with 95% confidence intervals (CI) were calculated using Cox
regression analysis adjusted for inverse propensity score weighting.
Overall, 384 patients with COVID-19 (212 males; median age 60 years)
were included in our study and were treated with tofacitinib (n=131) or
standard of care alone (n=253). The percentages of patients who started
mechanical ventilation or died during hospitalization in the tofacitinib
and control groups were 12.5% (9/72) vs. 14.1% (26/185) among patients
who required respiratory support (HR 0.92, 95% CI 0.33-2.56), and 1.7%
(1/59) vs. 4.4% (3/68) in those with normal oxygen saturation (HR 0.83;
95% CI 0.07-9.44). Tofacitinib did not reduce the risk of invasive
mechanical ventilation or death in patients with COVID-19, although the
analysis of these outcomes favored tofacitinib.
Key words. COVID-19, JAK-inhibitors, tofacitinib.