Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting

  • Roberto Ovilla-Martinez Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico
  • Xochitl Cota-Rangel Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico
  • Jose De La Peña-Celaya Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico
  • Mariana Alejandra Alvarado-Zepeda Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico
  • Alejandro Jiménez Sastré Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico
  • Humberto Azuara Forcelledo Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico
  • Bernardino Ordoñez Rodriguez Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico
  • Juan Pulido Broca Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico
  • Aaron Molina Jaimes Infectology, ISSSTE Hospital Regional Tipo B de Alta Especialidad Bicentenario de la Independencia, Tultitlan de Mariano Escobedo, Mexico
  • Alejandro Muñiz-Carvajal Internal Medicine, Hospital General De Cancún "Jesús Kumate Rodriguez", Cancun, Quintana Roo, Mexico
  • Maria Magdalena Bahena García Hematology, Hospital Central Sur de Alta Especialidad PEMEX, Mexico City, Mexico
  • Eduardo Cervera Ceballos Hematology, Medica Sur, Mexico City, Mexico
  • Nidia Paulina Zapata Canto Hematology, Medica Sur, Mexico City, Mexico
  • Jorge Oscar García Mendez Hematology, Medica Sur, Mexico City, Mexico
  • Omar Noel García Jímenez Internal Medicine, Hospital General Regional No 66 IMSS, Ciudad Juarez, Chihuahua, Mexico
  • Jesus Alberto Salas Heredia Intensive Care, Hospital Star Medica Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico
  • Javier Solis Soto Intensive Care, Hospital Star Medica Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico
  • Ruben Alberto Villalobos Mendez Intensive Care, Hospital Regional de PEMEX Salamanca, Salamanca, Guanajuato, Mexico
  • Gregorio Ignacio Ibarra Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico
  • Cindy Ledesma de la Cruz Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico
  • Nora Araujo Martinez Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico
  • Jessi Juárez Lara Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico
  • Cecilio Omar Ceballos Zuñiga Pneumology, Hospital de la Familia, Mexicali, Baja California, Mexico
  • Felipe Vicente Villaseñor Pérez Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico
  • Jose Carlos Herrera Garcia Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico
  • Patricia Nuche Salazar Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico
  • Alfredo Dominguez Paregrina Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico
  • Bertha Arizpe Bravo Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico
  • Gabriela Enciso Figueroa Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico
  • Teresita Trujillo Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico
  • Adriana Miguel Álvarez Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico
  • Diego de Jesús García Gallegos Intensive Care, Hospital General de Zona 10 IMSS, Manzanillo, Colima, Mexico
  • Alejandro Ortiz Arroyo Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico
  • Claudia Ivette Solorzano Soto Intensive Care, Hospital General de Zona 18 IMSS, Playa del Carmen, Quintana Roo, Mexico
  • Hiram Javier Jaramillo Ramírez Internal Medicine, Hospital General de Mexicali, Mexicali, Baja California, Mexico
  • Ibis De la Cruz Hernández Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico
  • Sergio De Gante Martínez Internal Medicine, Hospital Angeles Ciudad Juárez, Ciudad Juarez, Chihuahua, Mexico
  • Guadalupe Esmeralda Montesinos Gómez Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico
  • Silvia Martínez Velasco Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico
  • Roberto García Graullera Internal Medicine, Hospital General de Zona 3 IMSS, Cancun, Quintana Roo, Mexico
  • Miguel Angel Vázquez López Internal Medicine, Hospital General de Zona 2 IMSS, Tuxtla Gutierrez, Chiapas, Mexico
  • Victor Itaí Urbalejo Ceniceros Hematology, Instituto Nacional de Cancerología, Mexico City, Mexico
  • Yolanda Lugo García Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico
  • Ana Itamar González Ávila Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico
  • Jorge Duque Rodriguez Hematology, Hospital Ángeles Chihuahua, Chihuahua, Chihuahua, Mexico
  • Rodolfo Ruiz Luján Internal Medicine, Hospital General de Mexicali, Mexicali, Baja California, Mexico
  • Violeta I. Rodríguez Rivera Gastroenterology, Gastroclinic, Torreon, Coahuila, Mexico
  • Lucio Soberanes Ramírez Intensive Care, Hospital General Agustín O' Horan, Merida, Quintana Roo, Mexico
  • Pamela Elena Baez-Islas Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico
Keywords: COVID-19, pneumonia, ruxolitinib, JAK/STAT inhibitors

Abstract

Introduction: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19.

Methodology: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician’s criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured.

Results: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients.

Conclusions: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.

Downloads

Download data is not yet available.

Author Biographies

Roberto Ovilla-Martinez, Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico

Hematology

Xochitl Cota-Rangel, Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico

Hematology

Jose De La Peña-Celaya, Hematology, Hospital Angeles Lomas, Huixquilucan, Mexico

Hematology

Mariana Alejandra Alvarado-Zepeda, Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico

Internal Medicine

Alejandro Jiménez Sastré, Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico

Internal Medicine

Humberto Azuara Forcelledo, Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico

Internal Medicine

Bernardino Ordoñez Rodriguez, Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico

Internal Medicine

Juan Pulido Broca, Internal Medicine, Instituto de Seguridad Social del Estado de Tabasco, Villahermosa, Tabasco, Mexico

Internal Medicine

Aaron Molina Jaimes, Infectology, ISSSTE Hospital Regional Tipo B de Alta Especialidad Bicentenario de la Independencia, Tultitlan de Mariano Escobedo, Mexico

Infectology

Alejandro Muñiz-Carvajal, Internal Medicine, Hospital General De Cancún "Jesús Kumate Rodriguez", Cancun, Quintana Roo, Mexico

Internal Medicine

Maria Magdalena Bahena García, Hematology, Hospital Central Sur de Alta Especialidad PEMEX, Mexico City, Mexico

Hematology

Eduardo Cervera Ceballos, Hematology, Medica Sur, Mexico City, Mexico

Hematology

Nidia Paulina Zapata Canto, Hematology, Medica Sur, Mexico City, Mexico

Hematology

Jorge Oscar García Mendez, Hematology, Medica Sur, Mexico City, Mexico

Infectology

Omar Noel García Jímenez, Internal Medicine, Hospital General Regional No 66 IMSS, Ciudad Juarez, Chihuahua, Mexico

Internal Medicine

Jesus Alberto Salas Heredia, Intensive Care, Hospital Star Medica Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico

Intensive Care

Javier Solis Soto, Intensive Care, Hospital Star Medica Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico

Intensive Care

Ruben Alberto Villalobos Mendez, Intensive Care, Hospital Regional de PEMEX Salamanca, Salamanca, Guanajuato, Mexico

Internal Medicine

Gregorio Ignacio Ibarra, Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico

Hematology

Cindy Ledesma de la Cruz, Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico

Hematology

Nora Araujo Martinez, Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico

Internal Medicine

Jessi Juárez Lara, Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico

Hematology

Cecilio Omar Ceballos Zuñiga, Pneumology, Hospital de la Familia, Mexicali, Baja California, Mexico

Pneumology

Felipe Vicente Villaseñor Pérez, Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico

Internal Medicine

Jose Carlos Herrera Garcia, Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico

Pneumology

Patricia Nuche Salazar, Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico

Intensive Care

Alfredo Dominguez Paregrina, Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico

Pneumology

Bertha Arizpe Bravo, Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico

Infectology

Gabriela Enciso Figueroa, Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico

Pulmonary Rehabilitation

Teresita Trujillo, Pneumology, Grupo Medico en Contra del Coronavirus, Puebla, Puebla, Mexico

Nutrition

Adriana Miguel Álvarez, Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico

Internal Medicine

Diego de Jesús García Gallegos, Intensive Care, Hospital General de Zona 10 IMSS, Manzanillo, Colima, Mexico

Intensive Care

Alejandro Ortiz Arroyo, Internal Medicine, Centro Medico de Especialidades Ciudad Juarez, Ciudad Juarez, Chihuahua, Mexico

Internal Medicine

Claudia Ivette Solorzano Soto, Intensive Care, Hospital General de Zona 18 IMSS, Playa del Carmen, Quintana Roo, Mexico

Intensive Care

Hiram Javier Jaramillo Ramírez, Internal Medicine, Hospital General de Mexicali, Mexicali, Baja California, Mexico

Internal Medicine

Ibis De la Cruz Hernández, Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico

Internal Medicine

Sergio De Gante Martínez, Internal Medicine, Hospital Angeles Ciudad Juárez, Ciudad Juarez, Chihuahua, Mexico

Internal Medicine

Guadalupe Esmeralda Montesinos Gómez, Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico

Internal Medicine

Silvia Martínez Velasco, Internal Medicine, Hospital General de Zona 46 IMSS, Villahermosa, Tabasco, Mexico

Internal Medicine

Roberto García Graullera, Internal Medicine, Hospital General de Zona 3 IMSS, Cancun, Quintana Roo, Mexico

Internal Medicine

Miguel Angel Vázquez López, Internal Medicine, Hospital General de Zona 2 IMSS, Tuxtla Gutierrez, Chiapas, Mexico

Internal Medicine

Victor Itaí Urbalejo Ceniceros, Hematology, Instituto Nacional de Cancerología, Mexico City, Mexico

Hematology

Yolanda Lugo García, Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico

Internal Medicine

Ana Itamar González Ávila, Hematology, Hospital General Regional 1 Dr. Carlos Mac Gregor Sanchez Navarro IMSS, Mexico City, Mexico

Hematology

Jorge Duque Rodriguez, Hematology, Hospital Ángeles Chihuahua, Chihuahua, Chihuahua, Mexico

Hematology

Rodolfo Ruiz Luján, Internal Medicine, Hospital General de Mexicali, Mexicali, Baja California, Mexico

Infectology

Violeta I. Rodríguez Rivera, Gastroenterology, Gastroclinic, Torreon, Coahuila, Mexico

Gastroenterology

Lucio Soberanes Ramírez, Intensive Care, Hospital General Agustín O' Horan, Merida, Quintana Roo, Mexico

Intensive Care

Published
2022-01-31
How to Cite
1.
Ovilla-MartinezR, Cota-RangelX, De La Peña-CelayaJ, Alvarado-ZepedaMA, Jiménez SastréA, Azuara ForcelledoH, Ordoñez RodriguezB, Pulido BrocaJ, Molina JaimesA, Muñiz-CarvajalA, Bahena GarcíaMM, Cervera CeballosE, Zapata CantoNP, García MendezJO, García JímenezON, Salas HerediaJA, Solis SotoJ, Villalobos MendezRA, Ignacio IbarraG, Ledesma de la CruzC, Araujo MartinezN, Juárez LaraJ, Ceballos ZuñigaCO, Villaseñor PérezFV, Herrera GarciaJC, Nuche SalazarP, Dominguez ParegrinaA, Arizpe BravoB, Enciso FigueroaG, Trujillo T, Miguel ÁlvarezA, García GallegosD de J, Ortiz ArroyoA, Solorzano SotoCI, Jaramillo RamírezHJ, De la Cruz HernándezI, De Gante MartínezS, Montesinos GómezGE, Martínez VelascoS, García GraulleraR, Vázquez LópezMA, Urbalejo CenicerosVI, Lugo GarcíaY, González ÁvilaAI, Duque RodriguezJ, Ruiz LujánR, Rodríguez RiveraVI, Soberanes RamírezL, Baez-IslasPE (2022) Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting. J Infect Dev Ctries 16:63-72. doi: 10.3855/jidc.15126
Section
Coronavirus Pandemic