A pharmacist shows a box of tocilizumab, which is used in the treatment of rheumatoid arthritis, at the pharmacy of Cambrai Hospital, France, on April 28, 2020.
Pascal Rossignol | Reuters
A drug used to treat people with rheumatoid arthritis appears to reduce the risk of death in hospitalized patients with severe Covid-19, especially when combined with the steroid dexamethasone, researchers at Oxford University said on Thursday.
Oxford researchers also found tocilizumab, an intravenous drug made by a division of Swiss pharmacist Roche, also shortened the duration of patients in the hospital and reduced the need for a ventilator. The study was part of the recovery trial, which has been testing a number of possible treatments for Covid-19 since March.
“Previous tocilizumab trials had shown mixed results and it was unclear which patients could benefit from treatment,” Peter Horby, a University of Oxford professor and researcher in any set of the Recovery trial, said in a statement. “We now know that the benefits of tocilizumab extend to all COVID patients with low oxygen levels and significant inflammation.”
A total of 2,022 patients were randomly selected to receive tocilizumab, which is marketed under the brand name Actemra, by intravenous infusion and compared with 2,094 patients randomly selected to receive standard care alone. The researchers said 82% of patients also took a steroid such as dexamethasone, another drug that has been found to reduce death in patients with sicker Covid-19.
The researchers said 596 patients in the tocilizumab group died in 28 days compared with 694 patients in the standard care group. This means that for every 25 patients treated with tocilizumab “an extra life would be saved,” Oxford researchers said.
According to the researchers, the drug increased the likelihood of discharge within 28 days from 47% to 54%. The benefits were seen in all patients, including those who needed mechanical ventilators in an intensive care unit, they added. Among patients who did not wear a ventilator before entering the trial, tocilizumab reduced the chance of progressing to invasive mechanical ventilation or death from 38% to 33%.
The researchers said that the use of tocilizumab in combination with dexamethasone appears to reduce mortality by about a third in patients who need oxygen and nearly half in those who need a ventilator.
The results of the Oxford study have not yet been published in a peer-reviewed journal.
Public health officials and infectious disease experts say world leaders will need a plethora of drugs and vaccines to end the pandemic, which has infected more than 107.4 million people and killed at least 2.3 million in just over two years. of one year, according to data compiled by Johns Hopkins University.
In the United States, the Food and Drug Administration has approved Gilead Sciences’ remdesivir antiviral drug as a treatment for patients with Covid-19 who is at least 12 years old and in need of hospitalization.
The FDA has authorized the use of two monoclonal antibody treatments, as well as two vaccines, from Pfizer and Moderna. The FDA is expected to release a third vaccine, from Johnson & Johnson, as early as this month.
Researchers at Oxford University established in March the randomized evaluation of Covid-19 therapy, or recovery trial, to find treatments for Covid-19. The trial has previously shown that hydroxychloroquine, lopinavir-ritonavir, azithromycin, and convalescent plasma have no benefit for patients hospitalized with Covid-19.
The trial is currently investigating aspirin, the anti-inflammatory baricitinib and colchicine, as well as the Regeneron antibody cocktail.