Pharmacist displays a carton of tocilizumab, used in the treatment of rheumatoid arthritis, at the pharmacy of Cambrai hospital, France, April 28, 2020.
Pascal Rossignol | Reuters
A drug used to treat people with rheumatoid arthritis appears to reduce the risk of death in patients hospitalized with severe Covid-19, especially when it was combined with the steroid dexamethasone, Oxford University researchers said on Thursday.
Oxford researchers also discovered tocilizumab, an intravenous drug manufactured by a division of Swiss pharmaceutical company Roche, has also reduced patients’ hospital stay and reduced the need for a ventilator. The study was part of the Recovery study, which tested a variety of potential treatments for Covid-19 since March.
“Previous tests with tocilizumab have shown mixed results and it was not clear which patients could benefit from the treatment,” said Peter Horby, a professor at the University of Oxford and deputy chief researcher of the Recovery study, 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 trade name Actemra, by intravenous infusion and were compared with 2,094 patients selected at random to receive only standard treatment. The researchers said 82% of patients also took a steroid like dexamethasone, another drug that reduced deaths in Covid-19’s sickest patients.
The researchers said that 596 patients in the tocilizumab group died within 28 days, compared with 694 patients in the standard treatment group. This means that for every 25 patients treated with tocilizumab, “an additional life would be saved,” said the Oxford researchers.
The drug increased the likelihood of a 28-day discharge from 47% to 54%, according to the researchers. The benefits were seen in all patients, including those requiring mechanical ventilators in an intensive care unit, they added. Among patients who did not use 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 for patients who require oxygen and almost half for those who require 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 variety of medicines 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 one year, according to data compiled by Johns Hopkins University.
In the United States, the Food and Drug Administration has approved remdesivir, an antiviral drug from Gilead Sciences, as a treatment for patients with Covid-19 who are at least 12 years old and who 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 authorized by the FDA later this month.
The Covid-19 Therapy Randomized Trial, or Recovery trial, was established 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, anti-inflammatory drugs baricitinib and colchicine, as well as the Regeneron antibody cocktail.