Supply of the drug Baricitinib to healthcare hospitals in Belarus

As a pathogenetic treatment for moderate forms of pneumonia in order to suppress hyperinflammation and the development of serious lesions of the lungs and other organs caused by COVID-19, specialists may consider prescribing baricitinib (belongs to the group of Janus kinase inhibitors) as an additional therapy (recommended dose: 4 mg once a day for 7-14 days). Baricitinib is included in the treatment regimens (Ministry of Health of the Russian Federation and Ministry of Health of the Republic of Belarus) for moderate forms of COVID-19 and progressive respiratory failure not associated with other causes (exacerbation of bronchial asthma, progression of heart failure, thrombosis, etc.) and the absence of symptoms bacterial infection.
Baricitinib is a selective immunosuppressant, reversible inhibitor of Janus kinase 1 and 2 (JAK1 and JAK2). Janus kinases (JAKs) are enzymes that transduce intracellular signals from cellular receptors for a number of cytokines and growth factors involved in hematopoiesis, inflammation, and immune response. As part of the intracellular signaling pathway, Janus kinases phosphorylate and activate STATs (signal transporters and transcription activators), which in turn activate gene expression in the cell. Baricitinib modulates these signaling cascades by partially inhibiting JAK1 and JAK2 enzymatic activity, thereby reducing STAT[1] phosphorylation and activation.
Indication for medical use of baricitinib, according to the instructions for medical use: treatment of moderate or severe active rheumatoid arthritis in adult patients with intolerance or lack of an adequate response to treatment with one or more basic antirheumatic drugs [2].
Taking into account the effect of baricitinib on the immune response by disrupting the transduction of intracellular signals from cellular receptors for a number of cytokines (IL-6) and growth factors, the presumed efficacy of baricitinib in the “cytokine storm” observed in severe COVID-19 is discussed [3].
1. Otdelenov V.A., Tsvetov V.M., Sychev D.A. Possibility to use barycytinib in patients with COVID-19, including for treatment of «cytokine storm». Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice. 2020;(4S):11-14. (In Russ.)
2. Ibid.
3. Ibid.