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Tofacitinib and its impact on Covid-19 treatment

Posted by LIZ DAVENPORT

A study coordinated by the Academic Research Organization (ARO), from the Hospital Israelita Albert Einstein, in partnership with Pfizer, brought news about the treatment of patients hospitalized because of Covid-19. Thus, he showed the effectiveness of the drug tofacitinib (Xeljanz) to reduce deaths from the disease and prevent respiratory failure. The work was published in the scientific journal New England Journal of Medicine, last Wednesday, June 16th.

The Brazilian research included the participation of 289 adult individuals from 15 health institutions, with a hospital stay of at most three days. They were diagnosed with the disease through RT-PCR and most had pneumonia caused by the coronavirus. To carry out the research, patients were divided into two groups, which were monitored for a period of 28 days.

In one of the groups, tofacitinib (10 mg) was administered orally, twice a day, in addition to the conventional treatment for Covid-19. That is, until discharge or during 14 days of hospitalization. During the same period, the other group also received conventional treatment coupled with placebo. Furthermore, 89.3% of the participants, during the hospitalization period, were medicated with glucocorticoids (mostly dexamethasone).

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Results

Thus, by comparing the two study populations, at the end of 28 days, the researchers observed a reduction in the risk of death by 37%. And yet, for those people without the need for mechanical or non-invasive ventilation, they found a reduction in the chances of progression to respiratory failure.

This is because the medication makes the formation of lung injury difficult. It prevents the severe inflammatory storm caused by Covid-19 . It is an exacerbated response of the immune system to having contact with the virus.

Tofacitinib is a group of Janus kinase inhibitors (JAKs), proteins involved in triggering inflammatory diseases. Thus, in the clinical trial, he was responsible for modulating the immune system, preventing excessive inflammation. In this way, it blocks the immune system’s excessive response to the coronavirus.

Currently, the drug is allowed in Brazil to be used in the treatment of rheumatoid arthritis, psoriatic arthritis and ulcerative colitis. As such, it has not yet been approved for Covid-19 treatment by any regulatory agency in the world.

According to the physician who conducted the study, Otavio Berwanger, there was no increase in side effects between the placebo group and the drug group. However, he cautions that it should not be administered at home. Patients need constant monitoring.

It is noteworthy that there is still no specific treatment for the infection caused by the new coronavirus. Therefore, this discovery may be one more possibility to avoid serious consequences of the disease.

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