Covid-19: WHO recommends tocilizumab after the good results of a large study

Covid-19: WHO recommends tocilizumab after the good results of a large study
Covid-19: WHO recommends tocilizumab after the good results of a large study

The available results left this element of uncertainty despite certain hopes. But according to a study published Tuesday and involving nearly 11,000 patients, a class of anti-inflammatory drugs, including tocilizumab, effectively reduces the risk of death in hospitalized Covid-19 patients.

In the wake of these results, the World Health Organization (WHO) on Tuesday recommended their use, at the same time as corticosteroids, in patients with severe cases of Covid-19, she announced. Intravenous tocilizumab had shown mixed results in various smaller clinical trials, but this study, published in the scientific journal JAMA, compiles the results of 27 clinical trials in 28 countries. It is the first to cover such a large number of people.

A way to fight against hyper-inflammation

According to its main author, Manu Shankar-Hari, professor at King’s College London, this is “definitive evidence”. This analysis focused on the monoclonal antibodies sarilumab and tocilizumab, drugs originally used against rheumatoid arthritis. They are called interleukin 6 antagonists because they block the receptor for this protein. However, the latter plays a role in the immune overreaction process sometimes triggered by the coronavirus, leading to hyper-inflammation responsible for the most serious cases of Covid-19.

Among hospitalized patients, giving one of these two drugs at the same time as corticosteroids reduced the risk of death by 17%, compared to using corticosteroids alone. Corticosteroids like dexamethasone, which also have an anti-inflammatory effect, were the first treatment to prove to reduce mortality from Covid-19.

In detail, this study studied 10,930 patients, of which 6,449 received treatment (sarilumab or tocilizumab), and 4,481 received usual care or a placebo. The risk of dying after 28 days among the treatment group was 22%, compared to 25% for the others. By isolating only people who received treatment and corticosteroids at the same time, the risk of death even dropped to 21%.

Other encouraging studies

In addition, the risk of having to use an artificial respirator was also reduced with treatment. “Science has done its job, now we need to turn our attention to access issues,” WHO official Janet Diaz said in a statement. “Given the global inequalities for vaccines, people in the poorest countries are the most at risk for severe cases of Covid-19. They are the ones these drugs must reach. “

Tocilizumab is marketed under the name Actemra or RoActemra depending on the markets where it is sold. A British study, published in February, had already reported encouraging results concerning it. Conducted as part of the large Recovery clinical trial, this study of 4,000 hospitalized patients showed a reduction in the risk of death and the need for artificial respiration.

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Covid19 recommends tocilizumab good results large study

 
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