Mechanism of baricitinib supports artificial intelligence-predicted testing in COVID-19 patients
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Published version
Author(s)
Type
Journal Article
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 a 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 supports its assessment in randomized trials in hospitalized COVID-19 patients.
Date Issued
2020-08-07
Date Acceptance
2020-05-28
Citation
EMBO Molecular Medicine, 2020, 12 (8), pp.1-15
ISSN
1757-4676
Publisher
Wiley
Start Page
1
End Page
15
Journal / Book Title
EMBO Molecular Medicine
Volume
12
Issue
8
Copyright Statement
© 2020 Eli Lilly and Company. Published under the terms of the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/)
License URL
Sponsor
National Institute for Health Research
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32473600
Grant Number
NIHR-RP-011-053
Subjects
Baricitinib
COVID-19
anti-cytokine
anti-viral
case series
Publication Status
Published
Coverage Spatial
England
Article Number
e12697
Date Publish Online
2020-06-24