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Combination of Ruxolitinib and Eculizumab for Treatment of Severe SARS-CoV-2-Related Acute Respiratory Distress Syndrome: A Controlled Study

by Giudice, Valentina , Selleri, Carmine , Filippelli, Amelia , Serio, Bianca , Borrelli, Anna , Polverino, Benedetto Maria , Vecchione, Carmine , Cuffa, Bianca , Masullo, Alfonso , Pagliano, Pasquale , Gammaldi, Renato , Vitale, Carolina , Poto, Sergio , Sellitto, Carmine , Maglio, Angelantonio , Vatrella, Alessandro

in Antibiotics / ARDS (acute respiratory distress syndrome) / Blood / Blood platelets / Chronic obstructive pulmonary disease / Clinical outcomes / Complement component C5a / COVID-19 / Cytokines / Dehydrogenases / Disease prevention / Drug dosages / eculizumab / Hemoglobin / Immune response / Inflammation / Intensive care / JAK inhibitor / Janus kinase / Medical diagnosis / Monoclonal antibodies / Neutrophils / Permeability / Pharmacology / Pulmonary lesions / Respiratory distress syndrome / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Thrombosis / Viral infections

2020

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Combination of Ruxolitinib and Eculizumab for Treatment of Severe SARS-CoV-2-Related Acute Respiratory Distress Syndrome: A Controlled Study

2020

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Combination of Ruxolitinib and Eculizumab for Treatment of Severe SARS-CoV-2-Related Acute Respiratory Distress Syndrome: A Controlled Study

2020

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Journal Article

Combination of Ruxolitinib and Eculizumab for Treatment of Severe SARS-CoV-2-Related Acute Respiratory Distress Syndrome: A Controlled Study

Giudice, Valentina,

Selleri, Carmine,

Filippelli, Amelia,

Serio, Bianca,

Borrelli, Anna,

Polverino, Benedetto Maria,

Vecchione, Carmine,

Cuffa, Bianca,

Masullo, Alfonso,

Pagliano, Pasquale,

Gammaldi, Renato,

Vitale, Carolina,

Poto, Sergio,

Sellitto, Carmine,

Maglio, Angelantonio,

Vatrella, Alessandro

2020

Overview

To date, there are no specific therapeutic strategies for treatment of COVID-19. Based on the hypothesis that complement and coagulation cascades are activated by viral infection, and might trigger an acute respiratory distress syndrome (ARDS), we report clinical outcomes of 17 consecutive cases of SARS-CoV-2-related ARDS treated (N = 7) with the novel combination of ruxolitinib, a JAK1/2 inhibitor, 10 mg/twice daily for 14 days and eculizumab, an anti-C5a complement monoclonal antibody, 900 mg IV/weekly for a maximum of three weeks, or with the best available therapy (N = 10). Patients treated with the combination showed significant improvements in respiratory symptoms and radiographic pulmonary lesions and decrease in circulating D-dimer levels compared to the best available therapy group. Our results support the use of combined ruxolitinib and eculizumab for treatment of severe SARS-CoV-2-related ARDS by simultaneously turning off abnormal innate and adaptive immune responses.

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Publisher

Frontiers Media SA,Frontiers Media S.A

Subject

Antibiotics

/ ARDS (acute respiratory distress syndrome)

/ Blood

/ Blood platelets

/ Chronic obstructive pulmonary disease

/ Clinical outcomes

/ Complement component C5a