Evidence map›Paper›PMID 37593883›Full record

Observational studyPharmacotherapy2024

Baricitinib versus tocilizumab in critically ill COVID-19 patients: A retrospective cohort study.

Grace M Conroy, Seth R Bauer, Andrea M Pallotta, Abhijit Duggal, Lu Wang, Gretchen L Sacha

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Pharmacotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Grace M ConroyDepartment of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-7667-7347
Seth R BauerDepartment of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-0420-0320
Andrea M PallottaDepartment of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.
Abhijit DuggalRespiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0003-4220-2359
Lu WangDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
Gretchen L SachaDepartment of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-0070-8100
Cleveland Clinic · US

Funding

CCC for NHLBI Prevention and Early Treatment of Acute Lung Injury PETAL NetworkU01HL123009 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI FOULKES, ANDREA S, THOMPSON, BOYD TAYLOR · 2014 to 2021
$67.2M
Personalized vasopressor therapy in patients with septic shockK08GM147806 · NIGMS · CLEVELAND CLINIC LERNER COM-CWRU · PI SETH BAUER · 2022 to 2026
$886k
NHLBI NIH HHS U01 HL123009NIGMS NIH HHS K08 GM147806NIH HHS
6 · The paper itself

Abstract

objectivesThe immunomodulators tocilizumab and baricitinib improve outcomes in severely ill patients with coronavirus disease 2019 (COVID-19); however, comparative analyses of clinical outcomes related to these agents are lacking. A tocilizumab national shortage shifted treatment to baricitinib in critically ill patients, allowing for an outcome comparison in a similar population. The purpose of this study is to compare clinical outcomes in critically ill COVID-19 patients who received tocilizumab and those who received baricitinib.

designRetrospective, observational cohort study using generalized estimating equation models, accounting for clustering by hospital and known confounders, to estimate the proportional odds of the ordinal World Health Organization Clinical Progression Scale (WHO-CPS) score at day 14, the primary outcome. Secondary outcomes included WHO-CPS score at day 7.

settingMultiple hospitals within the Cleveland Clinic Health System. PATIENTS: Adult patients admitted for COVID-19 between January 2021 and November 2021.

interventionsReceipt of tocilizumab, before its shortage, or baricitinib, during shortage. MEASUREMENTS AND MAIN

resultsIn total, 507 patients were included; 217 received tocilizumab and 290 received baricitinib. Over 96% of patients required ICU admission and 98% received concomitant dexamethasone. Tocilizumab recipients had higher (worse) baseline WHO-CPS scores. After adjustment, tocilizumab use was associated with higher odds of a worse day 14 WHO-CPS score compared with baricitinib (adjusted odds ratio [OR] 1.65 [95% confidence interval (CI) 1.10-2.48]). Similarly, after adjustment, tocilizumab use was associated with higher odds of a worse day 7 WHO-CPS score (adjusted OR 1.65 [95% CI 1.22-2.24]).

conclusionsBaricitinib use was associated with better WHO-CPS scores at day 14 and day 7 compared with tocilizumab in a cohort of critically ill patients with COVID-19. The odds of having a one unit increase in WHO-CPS score at day 14 was 71% higher with tocilizumab than baricitinib. No difference in mortality or adverse effects was noted.

Indexed as

Antibodies, Monoclonal, HumanizedAzetidinesCOVID-19PurinesPyrazolesSulfonamidesAdultCOVID-19 Drug TreatmentCritical IllnessHumansRetrospective StudiesAntibodies, Monoclonal, HumanizedAzetidinesbaricitinibPurinesPyrazolesSulfonamidestocilizumabacute hypoxemic respiratory failurebaricitinibcoronavirus disease 2019critical illnessdrugtocilizumab

Identifiers

PMID37593883
PMCPMC10961678
OpenAlexW4385969360

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.