- Two new “life-saving” treatments can now be used in UK hospitals, because they reduce the risk of death by 24% in people seriously ill with coronavirus – according to a preliminary study.
- Tocilizumab and sarilumab, anti-inflammatory drugs commonly used for arthritis, can cut hospital stay by 10 days, the UK government announced on Thursday.
- The treatments have not been tested on people with coronavirus in wards of normal hospitals or in the community.
- “The bottom line is that although I have some concerns about the details of this study, if I were in intensive care with COVID, I would definitely like my doctors to give me tocilizumab now that I have read this article,” said Premier’s director of biostatistics Research, Adam Jacobs.
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Severely unwell patients with COVID-19 – the disease caused by coronavirus – can be treated with two potentially “life-saving” drugs commonly used for rheumatoid arthritis, the UK government announced on Thursday.
Tocilizumab and sarilumab reduced the likelihood of death from COVID-19 by 24% in patients treated with the drugs, compared with those who were not. They also spent 10 days less in the hospital, according to a government-funded study – the REMAP-CAP trial – that has not been peer-reviewed or published.
The study received £ 1.2 million ($ 1.63 million) of government support, according to the UK government.
“The data show that tocilizumab, and probably sarilumab, accelerate and increase the chances of recovery in intensive care, which is crucial to help relieve pressure on intensive care and hospitals and save lives,” said Professor Jonathan Van -Tam, from the UK’s Deputy Chief Medical Officer, in a statement on Thursday.
Health Secretary Matt Hancock said in a statement on Thursday that this was a “historic development” that will save “hundreds of lives”.
NHS doctors can treat patients in intensive care units with the drugs as early as Friday because supplies of tocilizumab are already in hospitals in the UK, the UK government said in the statement.
Tocilizumab and sarilumab are given as injections into a vein and given in conjunction with dexamethasone, a steroid treatment that is the usual care for people with COVID-19 who need oxygen. Dexamethasone is the “innovative” treatment, which has been shown to reduce the likelihood of death from COVID-19 in June.
The treatments are believed to work because they suppress the extra immune response seen in many patients with COVID-19 who are seriously ill, said Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, in a statement Thursday. by Insider.
Tocilizumab and sarilumab cost more than dexamethasone, with an indicative NHS drug cost of about £ 912 for each pre-filled injection, according to the British National Formulary. Dexamethasone costs about £ 20 per bottle.
Martin Landray, professor of medicine and epidemiology at the University of Oxford, said in a statement on Thursday that the results of the REMAP-CAP study “injected that little bit of optimism that we all need”, but there are unanswered questions.
It is not known whether these treatments work on people with early disease in hospital wards or in the community, for example.
“Exactly how does tocilizumab work in different types of patients?” said Landray.
Ongoing studies, such as the RECOVERY trial, are investigating whether the drugs can be used to prevent people from needing ventilators.
The REMAP-CAP study was not peer-reviewed, which means that the author’s numerical analysis was not examined by experts.
Professor Evans said the test was “high quality”.
Dr. Adam Jacobs, director of biostatistics at Premier Research, said in a statement seen by Insider on Thursday that complex methods need peer review. The researchers measure the success of the drug using a score that combines “mortality” and “number of days without organ support”, for example. Jacobs said that they are not comparable.
“Mortality is clearly much more important than an extra day of organ support,” he said.
There were also only a small number of patients treated with sarilumab, said Jacobs. This means that there is a certain risk that the results suggesting that sarilumab treatment is better than not taking it, may be due to chance. Jacobs said that tocilizumab was given to more patients and appears to work, however.
“There is an 8% absolute risk difference between tocilizumab and the control treatment. This means that if you administered it to 100 people in intensive care with COVID-19 infection, then eight more would be expected to survive than otherwise, “he said.
“The magnitude of the effect of tocilizumab does not make it a miracle cure, but it certainly makes it enough to be clearly useful,” he added.
The Department of Health and Social Care told Insider on Friday that both tocilizumab and sarilumab were recommended to doctors.
“The bottom line is that while I have some concerns about the details of this study, if I were in intensive care with COVID-19, I would definitely like my doctors to give me tocilizumab now that I read this article,” said Jacobs.