1116. Comparative Efficacy of Tocilizumab and Baricitinib in Treatment of Severe COVID-19 Infections


 
 
 Tocilizumab (TOCI) and baricitinib (BARI) have been shown to improve mortality in patients with severe COVID-19. However, there is limited comparative data between the two agents head to head. The purpose of this study was to evaluate patient characteristics and efficacy of BARI versus TOCI for the treatment of severe COVID-19.
 
 
 
 A retrospective, observational chart review was conducted during September 2020 to November 2021 in a three hospital health system in New Jersey. Hospitalized patients were included if they were ≥ 18 years old, requiring supplemental oxygenation and being treated for severe COVID-19 with TOCI. These patients were then matched based on BMI, age, and severity of hypoxemia with patients who received BARI. Patients were excluded if they required invasive mechanical ventilation (IMV) at the start of therapy. The primary outcome of the study was to assess incidence of all cause inpatient mortality (ACIM) in patients receiving TOCI or BARI. A subgroup analysis was performed that assessed clinical improvement and progression to IMV between both treatment groups. Secondary endpoints included analysis of independent variables associated with ACIM.
 
 
 
 Total of 194 patients were screened for eligibility and of these 87 patients in the TOCI group were matched with 87 patients in the BARI group. Overall, there was no difference seen in ACIM between TOCI compared to BARI (22% vs 33% OR 1.11 (0.49-2.71, P=0.18). For subgroup analysis, more patients in TOCI group experienced clinical improvement compared to BARI group (44% vs 22%, P=0.004). Additionally, patients in TOCI group were less likely to progress to require IMV (10% vs 26%, P=0.02). When logistic regression model was used to assess mortality predicting factors, patients receiving BARI who required ICU level of care (OR 2.10, CI 0.91-0.08, p=0.00055) and IMV (OR 2.40, CI 1.16-3.64, p=0.00015) had higher odds of ACIM compared to TOCI.
 Mortality predicting factors among patients receiving tocilizumab or baricitinib
 
 
 
 There was no difference seen in ACIM between TOCI and BARI. At the end of hospitalization patients receiving TOCI were more likely to experience clinical improvement compared to BARI. TOCI should be preferred in patients requiring ICU level of care and IMV.
 
 
 
 All Authors: No reported disclosures.
