Tocilizumab, baricitinib, olokizumab and dexamethasone: comparative characteristics and prognosis of efficacy in COVID-19

Due to the development of the «increased release of cytokines» syndrome in moderate and severe forms of COVID-19, anti-inflammatory therapy (AIT) is currently considered as the leading direction in the pathogenetic treatment of these forms of the disease. The aim of the study: to compare the effectiveness of AIT with dexamethasone, olokizumab, tocilizumab, baricitinib in COVID-19. Material and methods. A retrospective analysis of 229 cases of severe and moderate course of COVID-19 at Hospital of War Veterans (Saint Petrsburg) was performed, in which AIT was performed with dexamethasone, olokizumab, baricitinib, and tocilizumab. Calculations with a certainty of 95% or more were taken as statistically significant (p <0,05). The Bonferroni correction was used as a method for controlling the group error probability (of the first kind). Results and conclusion. During the study, differences in the outcome of the disease during AIT were established in the groups, a comparative analysis of patient subgroups was performed depending on the drug used. It was found that patients with an unfavorable outcome of COVID-19 had a later appointment of AIT, they needed more O2 support by the time it started. The volume of lung tissue damage according to the results of CT examination should be compared with the results of laboratory data, among which the most significant are CRP and D-dimer. The use of tocilizumab had the most significant effect on the decrease in mortality in the group of patients studied, and the use of dexamethasone was slightly less significant. At the same time, the significance of the effect of baricitinib and olokizumab on the outcome of AIT was comparable.

COVID-19, COVID-19, tocilizumab, baricitinib, dexamethasone, olokizumab, anti-inflammatory therapy, «cytokine storm», efficacy prediction