JAK Inhibition with Ruxolitinib in Patients with COVID-19 and Severe Pneumonia: Multicenter Clinical Experience from a Compassionate Use Program in Italy

Vannucchi, Alessandro Maria; Mortara, Andrea; D’Alessio, Andrea; Morelli, Mara; Tedeschi, Alberto; Festuccia, Moreno Benedetto; Monforte, Antonella D’Arminio; Capochiani, Enrico; Selleri, Carmine; Simonetti, Federico; Saracino, Annalisa; Rapezzi, Davide; Badagliacca, Maria Rita; Falasca, Katia; Molteni, Alfredo; Palazzolo, Roberto; Schettino, Giuliano; Bocchia, Monica; Turrini, Mauro; Ascierto, Paolo A.; Zuurman, Mike; Paley, Carole; Coco, Paola; Saglio, Giuseppe

Jak inhibitors are potent anti-inflammatory drugs that have the potential to dampen the hyperactive inflammatory response associated with severe COVID-19. We reviewed the clinical outcomes of 218 patients with COVID-19 hospitalized for severe pneumonia and treated with ruxolitinib through a compassionate use program. Data on the duration of treatment; outcomes at 4, 7, 14, and 28 days; oxygen support requirements; clinical status; and laboratory parameters were retrospectively collected. Overall, according to the physician evaluation, 66.5% of patients showed improvement at follow-up; of these, 83.5% showed improvement by day 7. Oxygen support status also showed improvement, and by day 7, 21.6% of patients were on ambient air, compared with 1.4% at baseline, which increased to 48.2% by day 28. Significant decreases in C-reactive protein and increases in the lymphocyte total count were already observed by day 4, which seemed to correlate with a positive outcome. At the end of the observation period, 87.2% of patients were alive. No unexpected safety findings were observed, and grade 3/4 adverse events were reported in 6.9% of patients.