Even with the mass vaccination and the decrease in the death toll, researchers around the world are still searching for drugs that can help in the treatment of the coronavirus. In Brazil, there are already 5 medicines released by Anvisa (National Health Surveillance Agency) for use in patients infected by the disease.
A new study of a drug already used to treat rheumatoid arthritis, a chronic disease that causes pain, swelling and inflammation in the joints, has shown a 38% reduction in mortality among people hospitalized for covid-19. The result was published on September 1 of this year in the journal The Lancet.
Baricitinib, an oral drug made by Eli Lilly, a pharmaceutical company, is able to inhibit the “inflammatory storm” that the coronavirus causes in the body. It is considered an overreaction of the immune system that can affect the functioning of organs, leading to the patient’s death.
“When administered at the right time, in addition to preventing the evolution of this inflammatory ‘cascade’ of the covid, it also prevents viral replication in the body”, explains Adilson Cavalcante, infectologist who coordinated the study at the Anchieta Hospital of the ABC School of Medicine (SP) .
The “right time” would be before the arrival of the inflammatory storm, which occurs after the patient’s clinical deterioration. The medication is only administered in hospitals, therefore, it is not possible to buy it in a pharmacy.
When the person is intubated, a group that was also included in the study, it is possible to administer it through a nasoenteral tube. But the baricitinib it is not indicated, for example, for mild cases of covid-19.
In Brazil, the drug is under evaluation by Anvisa and the company’s expectation is to receive regulatory approval this month.
How the study was done and the main results
The survey was conducted at 101 centers in 12 countries, with 1,525 patients in total. Brazil was the largest recruiter, with more than 360 participants divided into 18 centers in 5 states.
The study was carried out between June 2020 and January 2021.
Divided into two groups, the participants received baricitinib or placebo (a drug with no effect), in addition to other standard treatments of the institution.
Compared with placebo, patients who received baricitinib had a 38.2% relative reduction in mortality while hospitalized.
Although the study did not show a statistically significant benefit on the primary outcome (preventing the patient’s progression to a more severe stage of the disease), the result does show a reduction in mortality observed for this population of patients with covid.
The indication, from the study, is that patients use the drug between 12 and 14 days, but if it improves before this period, it is not necessary to continue its use at home, for example.
Contraindications and side effects
The study did not include children, pregnant women and people who were infected with other bacteria, for example. Baricitinib also has few drug interactions and can be used in elderly people with comorbidities.
As it is rapidly excreted by the body, it does not have many side effects. In some cases it can only cause symptoms of gastritis.
Access and Values
As it has not yet been approved by Anvisa for this purpose, there is still no information on the price. However, its value will be the same as already marketed to treat rheumatoid arthritis, according to Orlando Silva, director of corporate affairs and regulatory at the pharmaceutical company.
“The product will arrive at an affordable price for Brazilian hospitals and patients. The price, today, if we consider the 12-day treatment, would be R$ 1.8 thousand and, if it lasts 14 days, it would be R$ 2.1 thousand”, he explains .
In addition to private institutions, the idea is also to incorporate the drug into the public network, by Conitec (National Commission for the Incorporation of Technologies) in the SUS (Unified Health System).