The drug used to treat people with rheumatoid arthritis appears to reduce the risk of death in patients with highly serious Covid-19, especially when combined with the steroid dexamethasone, researchers at Oxford University have said on Thursday.
Oxford researchers also discovered tocilizumab, an intravenous drug developed by Swiss drugmaker Roche’s unit, which reduced hospital stays and reduced the need for a ventilator. The study was part of the RECOVERY trial, which explored a number of possible Covid-19 treatments since March.
Human Trials
“Previous trials of tocilizumab had shown mixed results, and it was unclear which patients might benefit from the treatment,” Peter Horby, a professor at the University of Oxford and joint chief investigator for RECOVERY, said 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, marketed under the brand name Actemra, internally and compared to 2,094 randomly selected patients to receive general care alone. Researchers say that 82% of patients also took a steroid such as dexamethasone, another drug that was found to reduce mortality in Covid-19 patients who became seriously ill.
Researchers say that 596 patients in the tocilizumab group died within 28 days compared with 694 patients in the general care group. That means that for every 25 patients treated with tocilizumab, “one single life will be saved,” Oxford researchers said.
Results
The drug increased the probability of discharge within 28 days 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 not on a ventilator before entering the trial, tocilizumab reduced the chance of progressing to invasive mechanical ventilation or death from 38% to 33%, the researchers said.
Researchers say that the use of tocilizumab in combination with dexamethasone appears to reduce the mortality rate by about one-third of patients who need oxygen and half of those who need a ventilator.
The results of the Oxford study have not yet been published in peer-reviewed journals.
Public health officials and infectious disease experts say world leaders will need a series of drugs and vaccines to end the COVID pandemic, which has infected more than 107.4 million people and killed at least 2.3 million in more than a year, according to data compiled by Johns Hopkins University.
In the U.S., Food and Drug Administration has approved the reintroduction of antimicrobial drugs at Gilead as a treatment for Covid-19 patients who are at least 12 years old and in need of 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 as early as this month.
