Rheumatoid Arthritis Drugs Reduce Risk of Death for Patients with Severe Covid-19 Disease, Researchers Say

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Preliminary results came from the RECOVERY trial, which has been testing possible treatments with Covid-19 since March 2020. Tocilizumab was added to the trial in April 2020. The results were shared in a prepress, but have not yet been reviewed or published in a medical journal.

For the trial, 2,022 patients were randomly assigned tocilizumab and compared with 2,094 patients receiving standard care.

“There were 596 deaths among the tocilizumab group, 29%, and there were 694 deaths, 33%, in the regular care group. Therefore, this is a reduction in the risk of death around ‘a sixth or a seventh’ Martin Landray, professor of medicine and epidemiology in the Department of Population Health at Nuffield at Oxford University, and chief investigator of the RECOVERY trial, said Thursday during a briefing.

“An absolute difference of four in every hundred,” Landray said. “You have to treat about 25 patients to save a patient, a life.”

Landray said the benefits were consistent across all patient groups studied.

The drug was also shown to have a benefit for people who did not have mechanical ventilation at the beginning of the trial; the risk of progressing to mechanical ventilation or death is reduced from 38% to 33%.

The benefits of the treatment were added to those of steroids such as dexamethasone: 82% of patients received one of these steroids.

“Data suggest that in patients with Covid-19 with hypoxia (requiring oxygen) and significant inflammation, treatment with the combination of systemic corticosteroids (such as dexamethasone) plus tocilizumab reduces mortality by approximately one-third for patients in need of simple oxygen. and almost half for those requiring invasive mechanical ventilation, ”said a Oxford University press release.

“It’s a treatment, in short, that reduces mortality, shortens the hospital stay, and reduces the chances of people needing invasive mechanical ventilators,” Landray said. “This is good for patients, this is good for healthcare. And this is good not only for healthcare and patients here in the UK, but also internationally.”

On February 3, a panel from the National Institutes of Health published treatment guidelines stating that for patients in the intensive care unit “there is not enough data to recommend for or against the use of tocilizumab or sarilumab for the treatment of Covid-19 “. Sarilumab is a similar treatment for rheumatoid arthritis. For those who did not need ICU-level care, the group recommended the use of medications except in a clinical trial.

Landray noted that many of the previous trials were minor and the results were unclear.

“Until these RECOVERY results, it has not been conclusive,” he said, even in other major trials, such as REMAP-CAP. When the RECOVERY results are added on top of others, “it’s completely clear.”

The National Health Service has a large number of patients who have been able to contribute to the trials, “this is how you get very clear answers and then you get the certainty that there were none before.”

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