Ruxolitinib for tocilizumab‐refractory severe COVID‐19 infection

Innes, Andrew J; Cook, Lucy B; Marks, Sasha; Bataillard, Edward; Crossette‐Thambiah, Christina; Sivasubramaniam, Gayathiri; Apperley, Jane; Milojkovic, Dragana

Whilst the majority of patients with COVID‐19 infection have mild self‐limiting symptoms, for some the SARS‐CoV2 virus can trigger a severe hyperinflammatory syndrome which is life threatening. Anti‐IL6 therapy has shown promise in restraining the hyperinflammatory syndrome and while IL‐6 is a pleiotropic mediatory of the inflammatory response, redundancy within inflammatory pathways means that the use of such targeted monoclonal therapy may have too restricted a repertoire in some patients. We present the case of a 53‐year‐old haematopoetic stem cell transplant recipient who developed a severe COVID‐19 that was refractory to anti‐IL6 therapy, but responded to Jak‐Stat inhibition with ruxolitinib, demonstrating its safety and efficacy in this setting.