Potential Therapeutic Agents
Baricitinib

Baricitinib

Notes

ID consultation is needed for the use of baricitinib for Covid-19

In rare circumstances, baricitinib can also be considered alone when dexamethasone cannot be used

For children with severe or critical illness, use of baricitinib should be evaluated on a case-by-case basis in consultation with the Pediatric Infectious Diseases team

When to Consider

Baricitinib has been shown to reduce mortality among patients who are not undergoing mechanical ventilation

Baricitinib can be considered in combination with dexamethasone in certain hospitalized patients who are exhibiting rapid respiratory decompensation due to COVID-19 meeting the following inclusion/exclusion criteria below:

Admitted to ICU < 24 hours and:

  • noninvasive mechanical ventilation
  • high-flow nasal canula oxygen (>0.4 FiO₂/30 L/min of oxygen flow)

OR

Recently hospitalized patients (not in an ICU) with:

  • Rapidly increasing oxygen needs who require NIV or HFNC and have significantly increased markers of inflammation

Without high suspicion of bacterial/fungal/mycobacterial infection

Dosing

4mg po daily for maximum of 14 days

eGFR ≥30 mL/min to <60 mL/min: Dose reduction to 2 mg PO daily

eGFR 15 mL/min to <30 mL/min: Dose reduction to 1 mg PO daily

eGFR <15 mL/min: Baricitinib is NOT recommended

Monitoring

  • Superinfection
  • VTE
  • GI perforation
  • TB activation