A new comprehensive analysis published in The Lancet Respiratory Medicine finds that Janus kinase (JAK) inhibitors should be considered first-line therapy for hospitalized Covid-19 patients.
Researchers reviewed data from nearly 13,000 adults across 16 randomized clinical trials conducted between May 2020 and March 2022. These studies compared the effectiveness of JAK inhibitors with other treatments, including dexamethasone and IL-6 blockers.
Key findings include:
- 11.7% mortality in the JAK inhibitor group vs 13.2% in the other treatments group by day 28.
- A 33% reduction in odds of death with JAK inhibitors after adjusting for individual risk factors.
- Reduced need for mechanical ventilation and quicker hospital discharge by approximately one day.
- Results were consistent regardless of vaccination status.
JAK inhibitors studied include:
- Xeljanz (tofacitinib) – Pfizer
- Olumiant (baricitinib) – Eli Lilly
- Rinvoq (upadacitinib) – AbbVie
“These results should inform World Health Organization Covid-19 treatment guidelines in the U.S. and Europe,” stated an accompanying editorial. The authors urged timely adoption of evidence-based therapies, even as Covid-19’s spread has slowed.
Early Induction of Labor May Prevent Birth Complications from Large Babies
New evidence from the Big Baby Trial, also published in The Lancet, suggests that early induction of labor in pregnancies with very large fetuses may reduce the risk of delivery complications such as shoulder dystocia, a serious emergency during childbirth.
The trial included 2,893 pregnant women whose fetuses were larger than 90% of peers for their gestational age. Participants were randomized into two groups:
- Standard care
- Induction of labor between 38 weeks and 38 weeks + 4 days
While overall rates of shoulder dystocia were similar due to some standard-care participants delivering early, targeted analysis showed:
- 2.3% shoulder dystocia in the induction group vs 3.7% in standard care among those delivering after 38 weeks.
- Babies in the induction group were born on average 8 days earlier and weighed 213 grams (about 8 ounces) less.
- 38% reduction in shoulder dystocia risk when adjusting for other risk factors.
- Lower cesarean delivery rates and fewer maternal complications in the induction group.
An editorial with the study noted that the findings align with previous research suggesting that early induction does not increase, and may even reduce, cesarean rates for pregnancies involving large babies.
New Bed Net Technology Targets Malaria Parasite, Not the Mosquito
A groundbreaking approach to malaria control may help restore the effectiveness of bed nets in regions with high insecticide resistance, according to a study published in Nature.
Rather than targeting mosquitoes directly, scientists at the Harvard T.H. Chan School of Public Health and Oregon Health & Science University have developed chemical treatments that attack the malaria parasite inside the mosquito.
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Key highlights:
- Researchers screened 81 experimental compounds from the endochin-like quinolone (ELQ) class.
- Two ELQs were found to block malaria parasite development by disrupting a key parasite protein.
- Effective even against insecticide-resistant mosquitoes.
- Compounds can be produced inexpensively and potentially integrated into existing bed net infrastructure.
“Malaria control desperately needs innovation,” said Dr. Flaminia Catteruccia, one of the study’s authors. Study leader Alexandra Probst added that the affordability and compatibility with current prevention tools make this a promising solution.
