People randomized to the Janus kinase (JAK) inhibitor baricitinib (Olumiant) to treat COVID-19 pneumonia in a clinical trial only saw a survival benefit if they had obesity, a post-hoc analysis found.

Death within 28 days of starting treatment occurred in 5.6% of patients with body mass index (BMI) values >30, compared with 9.2% of those assigned to placebo, according to Dennis G. McGonagle, MBBCh, PhD, of the University of Leeds in England, and colleagues.

The investigators had no solid explanation for how excess body fat could make baricitinib more effective in COVID-19 pneumonia. In previous studies, COVID-19, obesity, and JAK inhibition all appeared to promote thrombosis, such that baricitinib ought to worsen, not improve, survival in COVID patients with overweight/obesity. Responses to JAK inhibitors in rheumatologic diseases have, indeed, been found to be worse among individuals with obesity. Head over to MedPage Today to read the full story.