Autor : Cassetti, Isabel1-2
1 Helios Salud 2 Funcei
https://doi.org/10.56538/ramr.NKQX3269
Correspondencia : Isabel Cassetti. E-mail: isabelcassetti@gmail.com
By September, 2022, 609 031 330
cases of COÂVID-19 infection have been reported worldwide, with approximately 6
515 452 deaths. The U.S.A. is the country1 with the highest number of
diagnosed cases (288 583 per million people), with a total of 1 046 733 deaths,
followed by India and Brazil. According to some sources, Ecuador reported
approximately 998 202 cases and 35 876 deaths; this accounts for 57 182 cases
per million people. This has been a challenge for healthcare systems around the
world. After that avalanche of cases, the haste to find an effective treatment
is perfectly understandable. This led the Regulatory AuthoriÂties to be more
flexible about the technical and methodological requirements for drug approval;
although this sometimes allowed the use of certain treatments that in other
situations wouldn’t have been approved due to lack of information and cost. The
specific case of Janus-associated kinase (JAK) 1/2 inhibitors
is paradigmatic. Approved by the European Agency for the Evaluation of
Medicinal Products (2012) and the Food and Drug AdminisÂtration (2011) for the
treatment of myelofibrosis and polycythemia vera (2014),2 it was first used in patients diagnosed with
COVID-19 infection mostly as compassionate use, supported by small studies,
some non-randomized or weak, sometimes turning to physiopathological
explanations and using surrogate markers of questionable efficacy. In this
sense, studies were conducted comparing some treatments that could possibly be
effective against COVID-19 with other treatments that had already shown
efficacy (such as corticosteroids); in other cases, new treatments were
compared with other therapies that hadn’t shown a real benefit or at least left
unanswered questions (for example, hydroxychloroquine),
thus generating a dark inÂformative scenario from which we couldn’t obtain many
reliable conclusions. There were thousands of articles published around the
world, but only a few were good quality. Fortunately, after some time we
learned that some of these treatments apparently improved some important
outcomes, for example the JAK 1/2 inhibitors, which even in systematic reviews
seem to reduce mortality whatever the cause (on day 28 and day 60), comÂpared
to standard care,3 a fact that has
already been emphasized. Time and science will give us a clearer scenario about
the efficacy and safety of these treatments so that we can see these results in
patients in our daily practice, always taking into account the categorization
of their disease.
REFERENCES
1.
https://news.google.com/covid19/map?hl=es-419&gl=AR&ceid=AR%3Aes-419
2. Ajayi
S, Becker H, Reinhardt H, Engelhardt M, Zeiser R, von Bubnoff N. Ruxolitinib. Recent Results Cancer Res. 2018;212:119-32. https://doi.org/10.1007/978-3-319- 91439-8_6
3. Kramer A, Prinz
C, Fichtner F, Fischer AL, Thieme
V, Grundeis F, et al. Janus kinase inhibitors for the
treatment of COVID-19. Cochrane Database Syst Rev.
2022;6(6):CD015209
https://doi.org/10.1002/14651858.CD015209