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Severe pneumonia caused by COVID-19 has led to many deaths worldwide. Scientists around the world are studying whether some drugs and treatments used for other conditions might treat severe COVID-19 or related pneumonia. Now, a new study has found an arthritis drug developed by US biopharmaceutical Pfizer to be effective in reducing the risk of death or respiratory failure in hospitalised adult patients with Covid-19 pneumonia who were not on ventilation. Known as Tofacitinib, Pfizer's arthritis drug belongs to a class of drugs called Janus kinase (JAK) inhibitors. In the US, it is used to treat conditions like rheumatoid arthritis, psoriatic arthritis and ulcerative colitis.
The Hospital Israelita Albert Einstein in Brazil coordinated the trial in collaboration with Pfizer to test the efficacy of Tofacitinib in Covid-19 patients hospitalised with pneumonia. The study included 289 patients hospitalised with severe Covid-19 across 15 locations in Brazil. Half of these patients were given 10 mg Tofacitinib twice daily along with the standard of care which includes glucocorticoids, while the other half were prescribed placebo twice daily plus standard of care for up to 14 days.
After 28 days, tofacitinib was associated with 63 per cent lower risk of death or respiratory failure. The incidence of death or respiratory failure was only 18.1 per cent among patients on tofacitinib compared to placebo (29 per cent). While 2.8 per cent deaths occurred in the tofacitinib group, it was 5.5 per cent in the placebo group. But serious side effects occurred in 14.1 percent of patients in the tofacitinib group compared to the placebo group (12 percent). The results of the study were published in the New England Journal of Medicine.
Otavio Berwanger, Director of the Academic Research Organisation, Hospital Israelita Albert Einstein, believes that the use of tofacitinib in addition to standard of care may further reduce the risk of death or respiratory failure in patients hospitalised with Covid-19 pneumonia. However, he cautioned that tofacitinib has not been authorised for use by any regulatory authority worldwide for the treatment of Covid-19 and so it should not be used in patients with an active serious infection.
COVID-19 pneumonia may cause severe inflammation that can damage the lungs' alveoli, fluid accumulation in the lungs, and fluid leaking out of blood vessels in the lungs. The symptoms can vary from mild to severe, but common symptoms include coughing, loss of appetite, nausea, vomiting, shortness of breath, fever and difficulty breathing.
People with conditions that weaken the lungs or immune system such as cancer, diabetes, high blood pressure, severe heart disease, kidney or liver disease, asthma and other breathing disorders, may be more vulnerable to COVID-19 pneumonia. The risk is much higher in adults over 65 years of age.
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