Ruxolitinib

No deaths occurred in the ruxolitinib arm within the first 14 days of the trial. Ruxolitinib showed a numerically lower rate of severe pneumonia than standard of care (16.1% vs 24.6%), but this did not reach statistical significance. The RuxCoFlam trial demonstrated a significant benefit of ruxolitinib and used a composite inflammation score requiring far more extreme CRP elevations than MATIS. A low-to-intermediate ruxolitinib dose was chosen for MATIS out of concern for immunosuppression during the active phase of viral infection. Higher ruxolitinib doses or longer treatment durations may be more appropriate for more severe COVID-19. Ruxolitinib inhibits JAK1 and JAK2, thereby suppressing the JAK/STAT signalling pathway. Cytokine-induced STAT3 phosphorylation is inhibited within 2 hours of ruxolitinib administration, producing downstream reductions in TNF-alpha, IL-6, and CRP.