Results suggest that tocilizumab and sarilumab in patients with life-threatening infections improve outcomes
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Researchers found that two drugs used to treat rheumatoid arthritis could help save the lives of ICU patients with severe coronavirus. Early results of the international study suggested tocilizumab could improve treatment outcomes for patients with coronavirus infections that are life-threatening. Additional findings from a larger group of patients not only confirm the benefits of the drug, but also show that another arthritis drug, sarilumab, seems to be doing the same thing, not only saving lives but also reducing the time spent in intensive care by patients. Imperial College London’s Anthony Gordon, the leader of the U.K. Research behind the findings, he said he expects the drugs in the United Kingdom to be used in patients soon. “Both tocilizumab and sarilumab are so-called IL-6 receptor antagonists, which dampen the action of proteins that can cause an immune system overreaction,” he said.
The new results, which have not yet been peer-reviewed, come from a clinical trial called Remap-Cap (the community-acquired pneumonia randomized, embedded, multifactorial, adaptive platform), involving more than 3,900 Covid patients in 15 countries around the world. The latest study shows how researchers randomized adult patients with Covid to receive either standard care or an intravenous tocilizumab or sarilumab infusion within 24 hours of receiving organ support at the ICU. Results from 792 patients in six countries showed that tocilizumab and sarilumab both reduced the risk of death: while hospital mortality was 35.8% (142/397) for standard care, tocilizumab was 28.0% (98/350) and sarilumab was 22.2% (10/45).
The hospital mortality rate, combining the outcomes for the two drugs, was 27.3 percent (108/395)-a 24 percent relative reduction in death risk compared to the group receiving standard care. Gordon said, “Treat 12 patients and you save a life,” The team also found that patients treated with tocilizumab or sarilumab recovered faster and were able to leave the ICU about seven to 10 days earlier than patients treated with standard care. “The team also found that patients treated with tocilizumab or sarilumab recovered more quickly and were able to leave the ICU about seven to 10 days sooner than patients treated with standard care. ” Peter Horby, Oxford University professor of emerging infectious diseases and global health, who leads the recovery trial to test drugs for the treatment of covid patients but has not participated in the Remap-Cap trial, said the results are good news, noting that so far only dexamethasone and hydrocortisone steroids have saved lives on ventilators in covid patients.
“Since approximately 80% of patients also received dexamethasone or another steroid in the Remap-Cap trial, it appears, Horby said, that tocilizumab and sarilumab offer additional benefit. “In mechanically ventilated patients, we saw an absolute reduction in the risk of death of approximately 12% with dexamethasone [in the Recovery Study], and here you see an absolute reduction of approximately 8% -thaa percent- The data show that tocilizumab, and likely sarilumab, accelerate and improve ICU recovery, which is critical for decongesting and saving lives in ICUs and hospitals.