Pooled data from previous trials of Janus kinase (JAK)-inhibitor and type I interferon treatments for viral syndromes indicate they may be promising treatments for coronavirus disease 2019 (COVID-19), according to a meta-analysis published in BMC Infectious Diseases. Both treatments were previously found to be effective for viral infections, including coronaviruses such as severe acute respiratory syndrome and Middle East respiratory syndrome.
Investigators conducted a systematic review with MEDLINE and MedRxiv from their inception to July 30, 2020, for clinical trials involving a combination or monotherapy with JAK-inhibitor or type I interferon for COVID-19 treatment. The search required data with clearly indicated risk ratios or odds ratios (OR), or allowed for their back-calculation, and included adult, pediatric, observational, retrospective, randomized controlled, and case report studies.
Only 15 studies met the inclusion criteria. Analysis of clinical trials with JAK-inhibitor monotherapy showed significantly lower odds of mortality (OR, 0.12; 95% CI, 0.03-0.39; P =.0005) and ICU admission (OR, 0.05; 95% CI, 0.01-0.26; P =.0005), and higher odds of hospital discharge at 2 weeks (OR, 22.76; 95% CI, 10.68-48.54; P <.00001) compared to standard treatment (glucocorticoids, hydroxychloroquine, chloroquine, arbidol, and lopinavir/ritonavir).
Analysis of clinical trials with sole type I interferon treatment showed significantly lower odds of mortality (OR, 0.19; 95% CI, 0.04-0.85; P =.03) and higher odds of hospital discharge (OR, 1.89; 95% CI, 1.00-3.59; P =.05) compared to standard care (glucocorticoids, hydroxychloroquine, chloroquine, arbidol, and lopinavir/ritonavir).
Limitations included heterogenous outcome reporting and insufficient power among the studies, half of which had sample sizes less than 100. Investigators included prepublished articles to increase the statistical power of the meta-analysis.
“These results suggest the potential benefit of these therapeutic options for COVID-19,” the authors wrote, but emphasized the need for major randomized controlled studies on JAK-inhibitor and type I interferon treatments.
Walz L, Cohen AJ, Rebaza AP, et al. JAK-inhibitor and type I interferon ability to produce favorable clinical outcomes in COVID-19 patients: a systematic review and meta-analysis. BMC Infect Dis. Published online January 11, 2021. doi:10.1186/s12879-020-05730-z