An anti-inflammatory drug called tocilizumab reduces deaths and hospital stays in patients with severe COVID-19, according to preliminary data from a randomized trial of more than 4,000 patients.
Among the hospitalized patients requiring oxygen in the trial, there were 596 deaths in the group of 2022 patients randomly assigned to take tocilizumab – 29 percent died – and 694 deaths in the group of 2,094 patients randomly assigned to standard care – 33 percent are dead. This is an absolute difference of 4 percent in deaths and a decrease of 14 percent in the relative mortality rate.
Tocilizumab also appears to shorten hospital stays, increasing the chance that surviving patients can leave the hospital within 28 days of randomization from 47 percent to 54 percent.
Finally, it appears that the arthritis drug can help prevent disease to the point where patients require mechanical ventilation, which lowers the mechanical ventilation rate from 38 percent to 33 percent.
The benefits seen in the trial were in addition to the benefits already seen while using dexamethasone, an inexpensive, readily available, usable steroid drug found earlier to reduce deaths in COVID-19 patients. In both patient groups – tocilizumab and standard care groups – 82 percent of the patients were given dexamethasone.
The findings of the trial, which were published online but have not yet been reviewed by a peer, suggest that the combination of the two drugs could further degrade the mortality rate from the devastating pandemic.
Clear and welcome
However, compared to dexamethasone, tocilizumab is not as cheap, readily available or easy to use. The drug is a monoclonal antibody that essentially blocks the signal in the immune system that leads to inflammation. The antibody treatment should be administered intravenously, while dexamethasone may be administered orally, by injection or intravenously. And while dexamethasone can cost about $ 7 for a course, tocilizumab can cost as much as $ 700.
As such, tocilizumab is probably not a hit used everywhere in the fight against COVID-19. With the scarcity of effective treatments for serious diseases, doctors will still be eager to add it to their arsenal.
The data – from the massive RECOVERY trial in the UK – provide clarity to one of COVID-19’s many dark research areas. Seven smaller trials also looked at the use of tocilizumab to treat severe COVID-19 patients. However, the results were mixed and collectively unconvincing. PROCESSING, on the other hand, had more than three times as many deaths as all seven trials combined and was able to draw a clear conclusion.
“Previous trials with tocilizumab have shown mixed results, and it was unclear which patients would benefit from the treatment,” emerging infectious disease expert and co-leader of RESTEL Peter Horby said in a press release. ‘We now know that the benefits of tocilizumab extend to all COVID patients with low oxygen levels and significant inflammation. The dual impact of dexamethasone plus tocilizumab is impressive and very welcome. ”