Baricitinib for acute exacerbation in idiopathic interstitial pneumonias: A preliminary study using propensity score matching.

IF 3.8 3区医学 Q2 RESPIRATORY SYSTEM

Respiration Pub Date : 2025-07-10 DOI:10.1159/000547356

Hideaki Yamakawa, Shintaro Sato, Hiroki Ohta, Kenji Kusano, Moe Nomaki, Rie Kawabe, Chisa Uzuka, Hiroki Sasaki, Masako Amano, Tamiko Takemura, Jun Araya, Hidekazu Matsushima

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引用次数: 0

Abstract

Background and objective: Acute exacerbation of interstitial lung disease (AE-ILD) is a life-threatening complication for which there are only limited treatment options, with essentially no established treatment options. Janus kinase (JAK) inhibitors, such as baricitinib, have recently emerged as potential therapeutic candidates for severe and progressive forms of ILD. This study aimed to evaluate the efficacy and safety of baricitinib in patients with AE-ILD associated with idiopathic interstitial pneumonias (IIPs).

Methods: This retrospective cohort study included patients with IIPs who experienced AE-ILD, and were admitted to a single tertiary care center. Patients treated with baricitinib (Dec 2022-Jun 2024) were compared with historical controls (Jan 2021-Nov 2022). Propensity score matching (PSM) was conducted using age, PaO₂/FiO₂ ratio, and fibrosis score. The primary outcome was overall survival; secondary outcomes included 90-day survival and adverse events.

Results: After PSM, 17 patients were analyzed in each group. The 90-day survival rate in the baricitinib group (82.4%) was significantly higher than in the control group (52.9%, P = 0.049), while longer-term survival did not differ to a statistically significant extent. Baricitinib was well tolerated, with only mild adverse events observed. A trend toward improved 90-day survival was also noted with anti-fibrotic therapy administered during AE-ILD (P = 0.089).

Conclusions: Baricitinib may improve short-term survival in AE-ILD and was well tolerated in the acute phase. Its dual JAK1/2 inhibition suggests both anti-inflammatory and antifibrotic potential. Further prospective studies are needed to confirm these findings and explore combination therapies.

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Baricitinib治疗特发性间质性肺炎急性加重：一项使用倾向评分匹配的初步研究。

背景和目的：间质性肺疾病急性加重（AE-ILD）是一种危及生命的并发症，治疗方案有限，基本上没有确定的治疗方案。Janus kinase （JAK）抑制剂，如baricitinib，最近被认为是治疗严重和进行性ILD的潜在候选药物。本研究旨在评估巴西替尼对AE-ILD合并特发性间质性肺炎（IIPs）患者的疗效和安全性。方法：本回顾性队列研究纳入了在单一三级医疗中心就诊的经历AE-ILD的iip患者。接受巴西替尼治疗的患者（2022年12月- 2024年6月）与历史对照（2021年1月- 2022年11月）进行比较。使用年龄、PaO₂/FiO₂比率和纤维化评分进行倾向评分匹配（PSM）。主要终点是总生存期；次要结局包括90天生存率和不良事件。结果：经PSM治疗后，每组分析17例。baricitinib组90天生存率（82.4%）显著高于对照组（52.9%,P = 0.049），较长期生存率差异无统计学意义。Baricitinib耐受性良好，仅观察到轻微不良事件。AE-ILD期间给予抗纤维化治疗也有改善90天生存率的趋势（P = 0.089）。结论：Baricitinib可以改善AE-ILD的短期生存，并且在急性期耐受性良好。它的双重JAK1/2抑制表明具有抗炎和抗纤维化的潜力。需要进一步的前瞻性研究来证实这些发现并探索联合治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.