Two mechanisms of action
To better understand how baricitinib may causing this beneficial effect, the scientists studied its impact on miniature human organs grown in a laboratory.
This confirmed the initial findings of the AI software: that baricitinib reduces inflammation and makes it more difficult for the virus to access a person’s cells.
A leading cause of death for people with COVID-19 has been acute respiratory distress syndrome. This occurs when a person’s inflammatory response to SARS-CoV-2 goes out of control, damaging respiratory system cells and potentially affecting many other organs in their body.
The scientists found that this inflammatory response can also make it easier for the virus to enter a person’s cells as it replicates itself within their body.
Baricitinib seems to work by reducing both of these reactions, significantly increasing the chances of survival.
According to the study’s co-lead author Prof. Volker Lauschke, associate professor in Personalized Medicine and Drug Development at the Karolinska Institutet in Stockholm, Sweden, “[t]his study confirms what AI predicted, and what we were hearing from patient case reports.”
“For instance, one case involved an 87-year-old severely unwell patient from Foggia, Italy, who showed rapid improvement after being given the drug, whereas her husband and son, who did not receive baricitinib, died.”
“This study has also shone a light on exactly how this drug may protect us at the cellular level. This helps us understand why other types of drugs are proving beneficial, or not beneficial, as we help identify other treatments which may tackle COVID-19.”
– Prof. Volker Lauschke
The next step is to confirm the initial findings in larger, randomized controlled trials, which are already proceeding.
For Prof. Justin Stebbing, of the Department of Surgery and Cancer at Imperial College London, United Kingdom, and study co-lead author, “[w]e have seen the top-line results of a randomized study called the Adaptive Covid Treatment Trial-2 announced recently, showing benefits of baricitinib plus remdesivir, compared to remdesivir alone in over 1,000 patients.”
“Other very large trials occurring now include COV-BARRIER, and this will help create a fuller picture of the benefits and side effects of the oral medication (a small number of the patients in our study needed to stop the treatment due to problems with liver function).
“Further trials comparing baricitinib to other drugs in COVID-19 patients would also be helpful in improving outcomes.”
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