Mechanism of baricitinib supports artificial intelligence-predicted testing in COVID-19 patients.

Abstract:

:Baricitinib is an oral Janus kinase (JAK)1/JAK2 inhibitor approved for the treatment of rheumatoid arthritis (RA) that was independently predicted, using artificial intelligence (AI) algorithms, to be useful for COVID-19 infection via proposed anti-cytokine effects and as an inhibitor of host cell viral propagation. We evaluated the in vitro pharmacology of baricitinib across relevant leukocyte subpopulations coupled to its in vivo pharmacokinetics and showed it inhibited signaling of cytokines implicated in COVID-19 infection. We validated the AI-predicted biochemical inhibitory effects of baricitinib on human numb-associated kinase (hNAK) members measuring nanomolar affinities for AAK1, BIKE, and GAK. Inhibition of NAKs led to reduced viral infectivity with baricitinib using human primary liver spheroids. These effects occurred at exposure levels seen clinically. In a case series of patients with bilateral COVID-19 pneumonia, baricitinib treatment was associated with clinical and radiologic recovery, a rapid decline in SARS-CoV-2 viral load, inflammatory markers, and IL-6 levels. Collectively, these data support further evaluation of the anti-cytokine and anti-viral activity of baricitinib and support its assessment in randomized trials in hospitalized COVID-19 patients.

journal_name

EMBO Mol Med

journal_title

EMBO molecular medicine

authors

Stebbing J,Krishnan V,de Bono S,Ottaviani S,Casalini G,Richardson PJ,Monteil V,Lauschke VM,Mirazimi A,Youhanna S,Tan YJ,Baldanti F,Sarasini A,Terres JAR,Nickoloff BJ,Higgs RE,Rocha G,Byers NL,Schlichting DE,Nirula A

doi

10.15252/emmm.202012697

subject

Has Abstract

pub_date

2020-08-07 00:00:00

pages

e12697

issue

8

eissn

1757-4676

issn

1757-4684

journal_volume

12

pub_type

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