Repurposed drug reduces risk
COVID Study
Even with several vaccines to prevent COVID-19 on the market or in the works, researchers still have many questions about treating the disease. In the U.S., very few drugs have been authorized to treat COVID-19. Experts say the world will need more than just vaccines to completely end the pandemic. One study provided encouraging news about repurposing a drug to cut down on COVID deaths.
In study results released February 11, an FDA-approved, anti-inflammatory drug used to treat rheumatoid arthritis and severe or life-threatening cytokine release syndrome that is associated with chimeric antigen receptor (CAR) T cell therapy appears to reduce the risk of death in hospitalized patients with severe COVID-19. The drug is especially useful when combined with the steroid dexamethasone.
Tocilizumab, a humanized monoclonal antibody, binds to interleukin (IL)-6 receptors. Researchers observed that some people with COVID-19 develop a massive inflammatory response that can cause acute respiratory distress syndrome (ARDS), multiorgan failure, and potentially death. This massive systemic inflammatory response has been called a cytokine storm. Very high levels of IL-6 have been observed in these individuals, suggesting IL-6 may play a central role in the acute clinical decompensation. Thus, tocilizumab’s competitive inhibition of IL-6 binding to IL-6 receptors could potentially diminish this massive systemic inflammatory response.
As reported in The Hill (https://thehill.com/policy/healthcare/538461-study-shows-anti-inflammatory-drug-reduces-risk-of-death-in-hospitalized?rl=1 ), Tocilizumab, an intravenous drug from Roche, also appears to reduce the need for a mechanical ventilator and to shorten hospitalization time. The Recovery trial at the University of Oxford, which has been studying various potential treatments for COVID-19 since March, provided the preliminary results. The drug, sold as Actemra, was added to the clinical trial in April for COVID-19 patients who required oxygen and demonstrated inflammation.
According to Peter Horby, a professor at the University of Oxford and joint chief investigator for the Recovery trial, "Previous trials of tocilizumab had shown mixed results, and it was unclear 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 significant inflammation. The double impact of dexamethasone plus tocilizumab is impressive and very welcome."
In the trial 2,022 patients who were randomly allocated tocilizumab were tested. Results were compared with 2,094 patients who had standard care. Researchers said that 82 percent of the test subjects were also taking a steroid such as dexamethasone, which may also reduce hospitalization in people who have severe COVID-19. About 29 percent of the patients in the tocilizumab group died within 28 days, versus 33 percent of patients in the standard care group. The researchers said that the difference would save one additional life for every 25 patients treated with tocilizumab, and the drug also increased the probability of being discharged alive within 28 days from 47 percent to 54 percent.
Although the study provided no evidence that tocilizumab had any effect on the chances of successfully ending ventilation, the treatment significantly reduced the need for progressing to a ventilator or death, from 38 percent to 33 percent. Preliminary results will be submitted to a peer-reviewed medical journal in the near future.