The rheumatoid arthritis drug reduces the risk of death for critically ill patients with Covid-19, researchers say

The rheumatoid arthritis drug reduces the risk of death for critically ill patients with Covid-19, researchers say

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The preliminary results came from the RECOVERY trial, which has been testing potential Covid-19 treatments 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 by or published in a medical journal.

For the trial, 2,022 patients were randomly allocated with tocilizumab and compared with 2,094 patients who received standard treatment.

“There were 596 deaths among people in the tocilizumab group, 29%, and there were 694 deaths, 33%, in the usual care group. So this is a reduction in the risk of death by about a sixth or a seventh, “Martin Landray, professor of medicine and epidemiology at the University of Oxford’s Nuffield Department of Population Health, and deputy chief investigator of the RECOVERY study, said during a news conference on Thursday.

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

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

The drug also was shown to have a benefit for people who were not on mechanical ventilation at the start of the trial; the risk of progressing to mechanical ventilation or death decreases from 38% to 33%.

The benefits of the treatment were in addition to those of steroids such as dexamethasone – 82% of patients were receiving one of these steroids.

“The 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 about one third for patients requiring simple oxygen and almost half for those requiring invasive mechanical ventilation, “said a press release from the University of Oxford.

“This is a treatment, only in summary, that reduces mortality, shortens hospital stay and reduces the chances of people needing invasive mechanical ventilators,” said Landray. “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 internationally.”

On February 3, a panel from the National Institutes of Health released treatment guidelines that tell 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 do not need care at the ICU level, the panel recommended against using the drugs, except in a clinical trial.

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

“Until these RECOVERY results, he was inconclusive,” he said, even in other large studies, such as REMAP-CAP. When the RECOVERY results are added on top of others, “it becomes completely clear”.

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

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