Last week, the UK government issued a statement encouraging the use of tocilizumab and sarilumab, medications initially developed to improve arthritis symptoms, to treat severe COVID-19 cases. The recommendations are based on findings posted January 7 to the preprint server medRxiv that suggest the drugs could reduce the risk of death by 24 percent.
The study, which has not yet been peer-reviewed, evaluated around 800 patients in intensive care with severe COVID-19. Around half received the standard of care while 353 received tocilizumab and 48 received sarilumab. The researchers found that 35.8 percent of those given standard care died, compared with 28 percent who received tocilizumab and 22.2 percent who were given sarilumab.
“This is a significant step forward for increasing survival of patients in intensive care with COVID-19. The data shows that tocilizumab, and likely sarilumab, speed up and improve the odds of recovery in intensive care, which is crucial for helping to relieve pressure on intensive care and hospitals and saving lives,” Jonathan Van-Tam, the deputy chief medical officer for England, tells The Guardian.
The immunosuppressive drugs tocilizumab and sarilumab, which are primarily used to treat arthritis, block signaling of the cytokine IL-6, a key regulator of immune dysregulation and inflammation in severe COVID-19 cases. Dozens of clinical trials for the treatment of COVID-19 with tocilizumab and sarilumab are planned or underway, but published results regarding patient survival to date have been mixed.
The new study’s findings are “encouraging,” Krutika Kuppalli, an infectious disease physician at the Medical University of South Carolina who was not involved in the latest clinical trial, tells The New York Times. But, she adds, “I think we need to understand why this data looks different from other studies, before we start implementing this as widespread policy.”
The reason for the discrepancy may be because the new study included only patients with severe COVID-19, Jonathan Parr, an infectious diseases physician at the University of North Carolina at Chapel Hill who also was not part of the work, tells The Washington Post. In contrast, he says, “Other published randomized trials primarily enrolled hospitalized patients with less severe disease.” Patients in the new study also received the drugs within 24 hours of entering intensive care, suggesting that early treatment could be important for improving patient survival.