Arthritis drug reused to save life from severe Covid-19, UK trial results

Life-saving treatments for people with severe covid-19 are still scarce, bNew results from a large trial underway in the UK have revealed that a The arthritis medicine called tocilizumab can significantly reduce the risk of death in hospital patients, especially when combined with steroid therapy.

The RECOVERY – led by researchers at the University of Oxford in the UK – has been testing potential candidates for severe treatment of covid-19 since March 2020, with more than 36,000 participants enrolled to date. Their discoveries were among the first to to prove that the steroid dexamethasone has provided modest but real benefit in saving the lives of hospital patients requiring oxygen supply. The study also ruled out once promising treatments such as hydroxychloroquine and the anti-HIV cocktail lopinavir-ritonavir.

RECOVERY’s tocilizumab arm involved 2,022 patients randomized to receive the drug in addition to standard care, who were then compared to a group of similarly sized patients who received only standard care. Soon in this trial, which began in April 2020, steroids became standard treatment; as a result, 82% of patients also received steroids drugs too.

According to the results, published Thursday as a pre-print on MedRxiv, tocilizumab had a modest but clinically significant effect in reducing mortality. In the treatment group, 29% of patients died within 28 days, compared with 33% of control group patients. People on tocilizumab were also more likely to be discharged from the hospital within 28 days (54% vs. 47%). In truth-Worldwide terms, the drug is expected to save one in 25 patients who have taken he.

Although some previous research has found little or no benefit from using tocilizumab, the RECOVERY trial is by far the largest study to date to test its effectiveness, the authors noted. When combined with steroid therapy, they estimated that these drugs can reduce the risk of death by a third in patients on supportive oxygen and half for people on ventilators.

“Previous trials with tocilizumab had shown mixed results and it was not clear which patients might benefit from the treatment. We now know that the benefits of tocilizumab extend to all COVID patients with low oxygen levels and severe inflammation. The dual impact of dexamethasone and tocilizumab is impressive and very welcome, ”said Peter Horby, Emerging Infectious Diseases Researcher at Oxford and Co-Principal Investigator for RECOVERY, in a report. declaration published by the university.

Tocilizumab is a laboratory-made monoclonal antibody designed to suppress an overactive immune system – a common feature of severe covid-19. Unlike dexamethasone, which also suppresses the immune system, tocilizumab is still patented by the pharmaceutical company Roche and costs much more per dose. This may therefore have an impact on countries ‘or patients’ access to the medicine.

Nonetheless, given the continued need for reliable options, tocilizumab appears poised to be part of the toolbox for physicians dealing with these critical cases. And there may be even more treatments down the line. Another antibody-based arthritis medicine called sarilumab showed a similar rescue promise, while the FDA earlier this week authorized emergency use of an antibody cocktail developed by Eli Lilly for people at high risk of serious illness and hospitalization. In the United States, there are still more than 70,000 patients currently hospitalized with covid-19.

RECOVERY researchers are still testing several other drugs, including aspirin and two antibody drugs. They also plan to submit their preliminary results on tocilizumab to a peer-reviewed journal.