{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:57:42Z","timestamp":1793401062612,"version":"4.5.0"},"reference-count":23,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2023,7,25]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Immune dysregulation contributes to poorer outcomes in COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether abatacept, cenicriviroc, or infliximab provides benefit when added to standard care for COVID-19 pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>Randomized, double-masked, placebo-controlled clinical trial using a master protocol to investigate immunomodulators added to standard care for treatment of participants hospitalized with COVID-19 pneumonia. The results of 3 substudies are reported from 95 hospitals at 85 clinical research sites in the US and Latin America. Hospitalized patients 18 years or older with confirmed SARS-CoV-2 infection within 14 days and evidence of pulmonary involvement underwent randomization between October 2020 and December 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Single infusion of abatacept (10 mg\/kg; maximum dose, 1000 mg) or infliximab (5 mg\/kg) or a 28-day oral course of cenicriviroc (300-mg loading dose followed by 150 mg twice per day).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was time to recovery by day 28 evaluated using an 8-point ordinal scale (higher scores indicate better health). Recovery was defined as the first day the participant scored at least 6 on the ordinal scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 1971 participants randomized across the 3 substudies, the mean (SD) age was 54.8 (14.6) years and 1218 (61.8%) were men. The primary end point of time to recovery from COVID-19 pneumonia was not significantly different for abatacept (recovery rate ratio [RRR], 1.12 [95% CI, 0.98-1.28];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.09), cenicriviroc (RRR, 1.01 [95% CI, 0.86-1.18];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.94), or infliximab (RRR, 1.12 [95% CI, 0.99-1.28];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.08) compared with placebo. All-cause 28-day mortality was 11.0% for abatacept vs 15.1% for placebo (odds ratio [OR], 0.62 [95% CI, 0.41-0.94]), 13.8% for cenicriviroc vs 11.9% for placebo (OR, 1.18 [95% CI 0.72-1.94]), and 10.1% for infliximab vs 14.5% for placebo (OR, 0.59 [95% CI, 0.39-0.90]). Safety outcomes were comparable between active treatment and placebo, including secondary infections, in all 3 substudies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Time to recovery from COVID-19 pneumonia among hospitalized participants was not significantly different for abatacept, cenicriviroc, or infliximab vs placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT04593940\">NCT04593940<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jama.2023.11043","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T11:01:44Z","timestamp":1688986904000},"page":"328","source":"Crossref","is-referenced-by-count":76,"title":["Abatacept, Cenicriviroc, or Infliximab for Treatment of Adults Hospitalized With COVID-19 Pneumonia"],"prefix":"10.1001","volume":"330","author":[{"given":"Jane A.","family":"O\u2019Halloran","sequence":"first","affiliation":[{"name":"Washington University St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily R.","family":"Ko","sequence":"additional","affiliation":[{"name":"Duke University Health System, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Anstrom","sequence":"additional","affiliation":[{"name":"University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Kedar","sequence":"additional","affiliation":[{"name":"St Lawrence Health, Potsdam, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Reynold A.","family":"Panettieri","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson Medical School, New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Maillo","sequence":"additional","affiliation":[{"name":"Sanatorio Diagnostico, Santa Fe, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia Segura","family":"Nunez","sequence":"additional","affiliation":[{"name":"Hospital Nacional Hipolito Unanue, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Lachiewicz","sequence":"additional","affiliation":[{"name":"University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"National Center for Advancing Translational Sciences, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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