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LONDON (Reuters) – Roche’s arthritis drug tocilizumab reduces the risk of death in patients hospitalized with severe COVID-19, also shortening recovery time and reducing the need for mechanical ventilation, the results showed of a big test Thursday.
The results – from the RECOVERY trial, which has been testing a range of potential treatments for COVID-19 since March 2020 – should help clear up the confusion about whether tocilizumab has a benefit for COVID-19 patients after a series of recent mixed test results.
“We now know that the benefits of tocilizumab extend to all COVID patients with low oxygen levels and significant inflammation,” said Peter Horby, professor of emerging infectious diseases at the University of Oxford and co-principal investigator of the RECOVERY trial.
In June of last year, the RECOVERY trial found that the cheap and widely available steroid dexamethasone reduced death rates by about a third among the most seriously ill COVID-19 patients. This drug has since quickly become part of the recommended standard of care for severe patients.
Tocilizumab, sold under the brand name Actemra, is an intravenous anti-inflammatory monoclonal antibody used to treat rheumatoid arthritis. It was added to the trial in April 2020 for patients with COVID-19 who needed oxygen and showed signs of inflammation.
The study data was from 2,022 patients with COVID-19 who were randomly assigned to receive tocilizumab by intravenous infusion and who were compared to 2,094 patients randomly assigned to usual care alone. Researchers said that 82% of all patients were taking a systemic steroid such as dexamethasone.
The results showed that treatment with tocilizumab significantly reduced the number of deaths – 596 (29%) of patients in the tocilizumab group died within 28 days, compared to 694 (33%) patients in the usual care group.
This translates to an absolute difference of 4% and means that for every 25 patients treated with tocilizumab, an additional life would be saved, said Horby and his co-principal investigator Martin Landray.
They added that the benefits of tocilizumab clearly add to those of steroids.
“Used in combination, the impact is huge,” said Landray, who is also an Oxford professor of medicine and epidemiology.
He added that the results “clearly show the benefits of tocilizumab and dexamethasone in combating the worst consequences of COVID-19 – improving survival, shortening the hospital stay and reducing the need for mechanical ventilators.”
Roche’s pharmaceutical division chief Bill Anderson said last week that the previous mixed results were likely due to differences in the type of patients studied, when they were being treated and the end point – when the success or failure was measured.
“We think we’re sort of focusing on the most relevant metrics and the relevant patient population,” Anderson said. “It seems that the ideal candidates are patients who are really in this acute phase of an inflammatory crisis.”
Actemra, along with Sanofi’s similar drug Kevzara was cleared by the UK NHS in early January for COVID-19 patients in intensive care units after preliminary data from a smaller study called REMAP-CAP indicated that it could reduce hospital stays by about 10 days.
In 2020, Actemra became Roche’s fifth best-selling drug, at more than $ 3 billion, with nearly $ 600 million coming from the COVID-19 treatment.
Reporting by Kate Kelland in LONDON, with additional reporting by John Miller in ZURICH. Edited by David Evans
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