27 May JAK inhibitor Ruxolitinib Shows Promise in Mitigating Cytokine Storm of COVID-19

MedicalResearch.com Interview with:

Dr. Jian Feng Zhou

Jianfeng Zhou MD, PhD
Department of Hematology, Tongji Hospital
Tongji Medical College
Huazhong University of Science and Technolog
Wuhan, Hubei, China

MedicalResearch.com: What is the background for this study?

Response:  There is accumulating evidence on the key pathophysiological role of cytokines during the severe stage of COVID-19. In the context of lack of vaccine and specific antiviral agents, testing of immunomodulatory agents to reduce excessive or uncontrolled inflammation before it results in irreversible multi-organ dysfunction infection has received increasing research attention. Although several important papers have proposed JAK inhibitors as potential therapeutic targets, the role of JAK inhibitors on COVID-19 patients needs to be clarified quickly, especially in severe COVID-19 patients.

MedicalResearch.com: What are the main findings?

Response: Hence, we conducted a prospective, multicenter, single-blind, randomized controlled phase II trial to evaluate the efficacy and safety of ruxolitinib, a Janus-associated kinase (JAK1/2) inhibitor, for COVID-19. The results of the present study showed that ruxolitinib plus standard of care (SoC) was well tolerated in the treatment of severe COVID-19. It significantly mitigated exuberant cytokine storm featured in severe COVID-19, with significant chest CT improvement.  

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: The sample size was small due to no eligible patients available at the end of the pandemic at our trial centers. Additional larger controlled studies to confirm the possibility of a treatment benefit of ruxolitinib are needed.  Further testing in larger patient cohorts with different ethnicity or disease status is also required to get a comprehensive conclusion.

MedicalResearch.com: Is there anything else you would like to add?

Response: This is a first RCT investigation of JAK1/2 inhibitor for the treatment of severe COVID-19 worldwide based on a novel therapeutic rationale. Our conclusion has great clinical implication to manage cytokine storm in severe COVID-19 patients. The favorable side-effect profile combined with a reduction of inflammation and significant chest CT improvements in the ruxolitinib plus SoC treatment should inform future trials in a larger population to assess with ruxolitinib or other JAK1/2 inhibitors in COVID patients.

Citation: 

Ruxolitinib in treatment of severe coronavirus disease 2019 (COVID-19): A multicenter, single-blind, randomized controlled trial
Journal of Allergy and Clinical Immunology ( IF 14.110 ) Pub Date : 2020-05-26 , DOI: 10.1016/j.jaci.2020.05.019
Yang Cao; Jia Wei; Liang Zou; Tiebin Jiang; Gaoxiang Wang; Liting Chen; Liang Huang; Fankai Meng; Lifang Huang; Na Wang; Xiaoxi Zhou; Hui Luo; Zekai Mao; Xing Chen; Jungang Xie; Jing Liu; Hui Cheng; Jianping Zhao; Jianfeng Zhou

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Last Updated on May 27, 2020 by Marie Benz MD FAAD