Two arthritis drugs are extremely effective
GOOD NEWS from covid-19 wings are hard to come by today. A relentless increase in infections is overwhelming hospitals around the world. But the results of clinical tests on two drugs announced today only improved the prognosis, both for patients and for hospitals.
The two drugs, called tocilizumab and sarilumab, are currently used to reduce inflammation in patients with arthritis. Hyperinflammation, by means of which the immune system goes into excessive action and destroys the organs, is how covid-19 tends to kill. The search for suitable anti-inflammatories for covid-19 has already resulted in one, dexamethasone. It is a cheap steroid that dampens the immune system across the board. In contrast, tocilizumab and sarilumab are more targeted. Both are made of antibodies that block the effect of interleukin-6, a protein that stimulates the immune response and has been prominent in patients with covid-19.
The clinical trial of tocilizumab and sarilumab involved 800 patients hospitalized for covid-19 who were sick enough to require transfer to intensive care units (ICU). The trial was conducted in six countries, with the majority of participants in Britain. (He has an effective covid-19 drug testing program, in which a quarter of hospitalized patients are enrolled). Half of the 800 patients received one of the two drugs in addition to the standard treatment, and the other half received only the standard treatment (including dexamethasone).
Nearly 36% of patients in the standard treatment group died, compared with 27% of patients in the group who also received tocilizumab or sarilumab. In other words, it reduced the death rate by about a quarter. In addition, patients treated with these drugs recovered more quickly and were discharged from the hospital seven to ten days earlier. The reduction in hospital stay would free up many ICU beds – good news in places like Britain and the United States, where many hospitals are running out of beds.
Both drugs seem to work equally well, although the results are more certain for tocilizumab, which is an older drug, more widely available and therefore administered to the vast majority of participants in the study’s new treatment arm.
Medicines are not cheap and, therefore, may be beyond the possibilities of developing countries. In Britain, an intravenous treatment course costs £ 750-1,000 (about $ 1,000-1,400). The shorter stay in the ICU more than compensates for this value; a day in the ICU costs the country’s National Health Service (NHS) about £ 2,000 per patient. And in general, patients who spend less days in intensive care recover faster afterwards and need less rehabilitation.
The NHS will start using tocilizumab immediately for covid-19 patients in ICUs. Hospitals already have supplies of the drug and the government is working with Roche, the maker of the drug that makes it, to increase supplies. For the time being, Britain has banned exports of tocilizumab and sarilumab. As deaths from covid-19 continue, the test results bring a ray of hope to patients, exhausted health professionals and millions of people in prison.