Treatment Database

A JAK1/JAK2 inhibitor approved for rheumatoid arthritis, severe alopecia areata, and hospitalized adults with COVID-19 who need oxygen or ventilation. In the RECOVERY trial (Lancet 2022; 8,156 hospitalized patients), baricitinib reduced 28-day mortality from 14% to 12% (rate ratio 0.87), and across nine trials JAK inhibitors lowered COVID-19 deaths by about 20%. For Long COVID, it is being tested on the hypothesis that ongoing inflammation, possibly driven by persistent virus, sustains neurocognitive and cardiopulmonary symptoms through the JAK-STAT pathway. REVERSE-LC (NCT06631287) is a phase 3 randomized, placebo-controlled trial led by Vanderbilt (principal investigator E. Wesley Ely) with Emory, UCSF and the University of Minnesota, expanded in 2026 through NIH's RECOVER-TLC program to 17 sites. It aims to enroll 550 adults who have had Long COVID with cognitive impairment for at least 6 months, following them for one year to measure cognition, heart and lung function, post-exertional malaise and quality of life. No Long COVID results have been reported; completion is estimated for 2027. In lupus, Lilly ended phase 3 development in 2022 after one of two trials (SLE-BRAVE-I and II) missed its goal. Baricitinib carries a boxed warning for serious infections, mortality, malignancy, major cardiovascular events and blood clots, and requires monitoring of blood counts, liver enzymes and lipids.