A pharmacist shows a box of tocilizumab, which is used in the treatment of rheumatoid arthritis, in the pharmacy of the 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 hospitalized patients with severe Covid-19, especially when combined with the steroid dexamethasone, Oxford University researchers said Thursday.
Oxford researchers also found tocilizumab, an intravenous drug manufactured by a division of the Swiss drug manufacturer Roche, also shortened the length of hospital stay of patients and reduced the need for a ventilator. The study was part of the Recovery study, which has been testing a range of potential treatments for Covid-19 since March.
“Previous studies with tocilizumab had shown mixed results, and it was unclear which patients could benefit from the treatment,” said Peter Horby, a professor at the University of Oxford and joint lead investigator for 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 brand name Actemra, by intravenous infusion and compared with 2,094 patients randomly selected to receive standard care only. The researchers said 82% of patients were also taking a steroid such as dexamethasone, another drug found to reduce deaths in the sickest Covid-19 patients.
Researchers said that 596 patients in the tocilizumab group died within 28 days, compared to 694 patients in the standard care group. That means that for every 25 patients treated with tocilizumab, “one extra life is saved,” said Oxford researchers.
The drug increased the odds of discharge within 28 days from 47% to 54%, the researchers said. The benefits were seen in all patients, including those who required mechanical ventilators in an intensive care unit, they added. In patients who were not on a ventilator before starting the trial, tocilizumab reduced the chance of invasive mechanical ventilation or death from 38% to 33%, the researchers said.
The researchers said using tocilizumab in combination with dexamethasone appears to reduce mortality by about one-third for patients who need oxygen and nearly half for 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, according to Johns’ data, has infected more than 107.4 million people and at least Killed 2.3 million people. Hopkins University.
In the US, the Food and Drug Administration has approved Gilead Sciences’ antiviral drug remdesivir as a treatment for Covid-19 patients at least 12 years old who require hospitalization.
The FDA has approved the use of two monoclonal antibody treatments and two vaccines – from Pfizer and Moderna. A third vaccine, from Johnson & Johnson, is expected to be approved by the FDA as early as this month.
The Randomized Evaluation of Covid-19 Therapy trial, or Recovery trial, was founded in March by researchers at the University of Oxford to find treatments for Covid-19. The study has previously shown that hydroxychloroquine, lopinavir ritonavir, azithromycin and convalescent plasma are of no benefit to patients hospitalized with Covid-19.
The trial is currently investigating aspirin, anti-inflammatory drugs baricitinib and colchicine, as well as Regeneron’s antibody cocktail.