A pharmacist is displaying a box of tocilizumab, which is used to treat 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.
Researchers at Oxford also found tocilizumab, an intravenous medicine made by a division of the Swiss drug Roche also shortened the length of patients’ stays in hospitals and reduced the need for a ventilator. The study was part of the recovery process, which tested a number of potential treatments for Covid-19 in March.
“Previous studies with tocilizumab have shown mixed results and it was unclear which patients could benefit from treatment,” Peter Horby, a professor at Oxford University and joint chief investigator for the recovery process, 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 were compared with 2,094 patients randomly selected to receive standard single care. The researchers said that 82% of patients also took a steroid, such as dexamethasone, another drug that has been found to reduce deaths in patients with Covid-19.
The researchers said that 596 patients in the tocilizumab group died within 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,” said Oxford researchers.
The drug increased the likelihood of evacuation within 28 days from 47% to 54%, according to the researchers. The benefits were seen in all patients, including those who require mechanical ventilators in an intensive care unit, they added. Among patients who did not take a ventilator before entering the study, tocilizumab reduced the chance of progressing to invasive mechanical ventilation or death from 38% to 33%, the researchers said.
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 almost 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 range of drugs and vaccines to end the pandemic, which has infected more than 107.4 million people and killed at least 2.3 million people. just over a year, according to data compiled by Johns Hopkins University.
In the US, the Food and Drug Administration has approved Gilead Sciences’ antiviral remdesivir as a treatment for Covid-19 patients who are at least 12 years old and need hospitalization.
The FDA has authorized the use of two monoclonal antibody treatments, as well as two vaccines – from Pfizer and Moderna. A third vaccine from Johnson & Johnson is expected to be approved by the FDA later this month.
The randomized trial of Covid-19 therapy, or the recovery process, was set up in March by researchers at Oxford University to find treatments for Covid-19. The study previously showed that hydroxychloroquine, lopinavir-ritonavir, azithromycin and convalescent plasma have no benefits for patients hospitalized with Covid-19.
The trial is currently investigating aspirin, the anti-inflammatory drugs baricitinib and colchicine, as well as the Regeneron antibody cocktail.