1. Mechanism of baricitinib supports artificial intelligence-predicted testing in COVID-19 patients
- Author
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Stebbing, J, Krishnan, V, Bono, SD, Ottaviani, S, Casalini, G, Richardson, PJ, Monteil, V, Lauschke, VM, Mirazimi, A, Terres, JAR, Nickoloff, BJ, Higgs, RE, Rocha, G, Byers, NL, Schlichting, DE, Cardoso, A, Corbellino, M, National Institute for Health Research, and Imperial College Healthcare NHS Trust- BRC Funding
- Abstract
Baricitinib, is an oral Janus kinase (JAK)1/JAK2 inhibitor approved for the treatment of rheumatoid arthritis (RA) that was independently hypothesized, using artificial intelligence (AI)-algorithms, to be useful for the treatment of COVID-19 infection via a proposed anti-cytokine effects and as an inhibitor of host cell viral propagation1,2. 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, which express hAAK1 and hGAK. 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. 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. This represents an important example of an AI-predicted treatment showing scientific and clinical promise during a global health crisis. Collectively, these data support further evaluation of the AI-derived hypothesis on anti-cytokine and anti-viral activity and supports its assessment in randomized trials in hospitalized COVID-19 patients.
- Published
- 2020