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as a treatment for Ebola and had shown promise against other coronaviruses. With $796,757 from NIAID, the two studies were both Adaptive COVID-19 Treatment Trials (ACTT)—moving rapidly from exploratory clinical to confirmatory trials. The first ACTT study was the first clinical trial launched in the U.S. to evaluate an experimental treatment for COVID-19. It was a placebo-controlled trial enrolling 1,063 hospitalized adults with moderate to severe COVID-19 disease from 10 countries, including 15 participants from UIC. "Our study showed unequivocally that there was a benefit," says Novak. "While remdesivir is not a miracle drug, it did ameliorate the disease. The study results showed that remdesivir shortened the duration of hospitalization by one-third." The second ACTT trial teamed remdesivir with baricitinib, a drug used to treat rheumatoid arthritis that employs a Janus kinase inhibitor designed to suppress the body's inflammatory response. "Some patients with severe cases of COVID-19 experience acute respiratory distress due to inflammation in the lungs," says Novak. "Because baricitinib reduces inflammation, we wanted to see if it would reduce the im- mune response in COVID patients." There were 1,033 participants in the trial, with three enrolled at UIC. The study showed that combining baricitinib with remdesivir resulted in a one-day reduction in hospitalization and a 35% decrease in mortality versus remdesivir combined with a placebo. Ruling medications in—and out OTHER IMMUNOMODULATORS were also tested to help calm cytokine release syndrome—the systemic inflammatory response that some patients experience with COVID-19. "One cytokine, interleukin 6 (IL- 6), is a hallmark messenger activating the immune system," explains Krishnan. "Higher levels of IL-6 are associated with more severe COVID-19 and are predictive of respiratory failure needing mechani- cal ventilation. Results of some published observational studies suggested that monoclonal antibodies against IL-6 may improve outcomes in patients hospitalized with COVID-19. On the basis of these data, several hospitals in the U.S. and else- where started to use monocloncal antibod- ies against IL-6." Illinois Medicine participated in a randomized placebo-controlled clinical trial to test whether sarilumab, a drug already approved for rheumatoid arthritis, would be an effective blocker of IL-6, he P H O T O : L L O Y D D E G R A N E Illinois Medicine | 15 " " Tackling COVID-19 is the moon shot of our generation. With a new virus, many different sectors, including government, industry and academia, needed to come together to learn how to best care for patients and prevent this new disease. Jerry Krishnan, MD, PhD (above) Professor of Medicine and Public Health, Associate Vice Chancellor for Population Health Sciences