Infectious Disease

Tocilizumab reduces dying in critically sick COVID-19 sufferers

February 11, 2021

2 min read

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Healio was unable to confirm any relevant financial information for Horby and Landray at the time of publication.

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Compared to usual treatment, tocilizumab reduced deaths in patients with COVID-19 who needed oxygen and had signs of inflammation by an absolute difference of 4%, researchers from the RECOVERY study reported Thursday.

The data suggest that tocilizumab in combination with a systemic corticosteroid such as dexamethasone in patients with hypoxia and significant inflammation reduces mortality “by about a third in patients requiring simple oxygen and by around one-third in patients requiring invasive mechanical ventilation.” almost half decreased “press release of the investigators.

Tocilizumab graphic

Source: attempted recovery

The RECOVERY study previously showed that dexamethasone reduced the death of patients with COVID-19 who were ventilated or given oxygen. In the current study, the researchers said that tocilizumab’s benefits “were clearly seen on top of those of steroids”.

“Previous studies with tocilizumab had shown mixed results and it was unclear which patients might benefit from the treatment.” Peter Horby, MD, PhD, Professor of Emerging Infectious Diseases at Oxford University and joint investigator for the RECOVERY study, said in a statement. “We now know the tocilizumab benefits apply to all COVID patients with low oxygen levels and significant inflammation. The dual action of dexamethasone plus tocilizumab is impressive and very welcome. “

The RECOVERY study – RECOVERY stands for Randomized Evaluation of COVID-19 Therapy – has been evaluating numerous potential treatments for the disease for almost a year. Last month, researchers announced the end of a study examining convalescent plasma for the treatment of COVID-19 after the Independent Data Monitoring Committee found there was no evidence that it was benefiting patients.

Investigators added tocilizumab, an arthritis drug, to the study last April. The data reported Thursday was based on more than 4,000 patients randomly selected in equal proportions to receive either an IV infusion of tocilizumab or usual treatment. Of all patients, 82% were taking dexamethasone or another systemic steroid, the researchers said.

Among the patients in the treatment arm, 596 (29%) died within 28 days compared to 694 (33%) patients in the usual care arm (RR = 0.86; 95% CI 0.77-0.96) – an absolute difference of 4% investigators reported.

Tocilizumab had other benefits including increasing the likelihood of being alive on discharge within 28 days from 47% to 54% (RR = 1.23; 95% CI 1.12-1.34).

“These benefits have been seen in all patient subgroups, including those who require oxygen through a simple face mask to those who require mechanical ventilators in an intensive care unit,” the press release said.

Patients who did not receive mechanical ventilation were less likely to develop invasive mechanical ventilation if they received tocilizumab or if they died. However, the study found no evidence that tocilizumab helped discourage patients from using mechanical ventilation, the researchers said.

“The results of the RECOVERY study clearly show the benefits of tocilizumab and dexamethasone in combating the worst effects of COVID-19 – improving survival, reducing hospital stays and reducing the need for mechanical ventilators.” Martin Landray, MB. ChB, PhD, Professor of Medicine and Epidemiology at Oxford University and joint investigator for the study, said in a statement.

“When combined, the effect is significant,” said Landray. “This is good news for patients and good news for the health services they serve in the UK and around the world.”

When the Infectious Diseases Society of America updated its literature review on tocilizumab on Wednesday, it continued to recommend opting out of routine use of the drug in hospitalized patients treated for COVID-19. IDSA did not immediately respond when asked if it would re-examine these guidelines based on the results of the RECOVERY study.

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