New treatment ‘significantly’ reduces mortality in critically ill Covid patients, study finds

Tocilizumab and sarilumab both shown to improve chances of survival and recovery in patients admitted to intensive care

Samuel Lovett
Thursday 07 January 2021 20:05
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Two drugs typically used to treat rheumatoid arthritis have been shown to “significantly” reduce the risk of mortality in Covid-19 patients admitted to intensive care.

Under new NHS guidance to be issued by the government, critically ill patients hospitalised with the disease will be given access to tocilizumab and sarilumab, both of which are immunosuppressant drugs and can improve the chances of survival and recovery.

The government-funded Remap-Cap clinical trial found that the treatments reduced the risk of mortality to a quarter when administered to patients within a day of entering intensive care alongside a corticosteroid, such as dexamethasone – the first drug proven to reduce mortality.

Patients receiving this treatment also left intensive care between seven to 10 days earlier on average, the study added.

Matt Hancock described the news as “another landmark development in finding a way out of this pandemic”, while professor Jonathan Van-Tam, England’s deputy chief medical officer, said it marked a “significant step forward for increasing survival of patients in intensive care”.

The findings, which have been submitted to a peer-reviewed journal, are based on an analysis of 803 patients, 353 of whom had been assigned to tocilizumab and 48 to sarilumab.

The majority of patients were also treated with corticosteroids and were receiving respiratory support.

Hospital mortality was 27.3 per cent among patients receiving tocilizumab or sarilumab, compared with 35.8 per cent of patients in the control group who did not receive the drugs, the researchers said.

The majority of patients were also treated with corticosteroids and were receiving respiratory support.

Professor Anthony Gordon, chief investigator of the Remap-Cap trial, said: "This is a significant finding which could have immediate implications for the sickest patients with Covid-19.

"We found that among critically ill adult patients – those receiving breathing support in intensive care – treatment with these drugs can improve their chances of survival and recovery.

"At a time when hospitalisations and deaths from Covid-19 are soaring in the UK, it's crucial we continue to identify effective treatments which can help to turn the tide against this disease.

"For every 12 patients you treat with these drugs you would expect to save a life. It's a big effect."

Martin Landray, a professor of medicine and epidemiology at University of Oxford, said the findings demonstrated “the incredible power of well-conducted randomised trials, delivered by frontline NHS staff at the bedside, to identify which of the many treatments we hope might work actually have real benefits for patients”.

Prof Van-Tam added that the use of tocilizumab or sarilumab in severely ill patients hospitalised with Covid would “improve the odds of recovery in intensive care, which is crucial for helping to relieve pressure on intensive care and hospitals and saving lives".

Tocilizumab and sarilumab have been added to the government's export restriction list, the Department of Health and Social Care (DHSC) said.

This will protect supply for UK patients by enforcing regulatory action on those who flout the restrictions, it added.

Treatment with tocilizumab or sarilumab is thought to cost somewhere between £750 and £1,000 and is administered intravenously either as a one or two dose regime.

The drugs work to suppress the body’s immune system, which often flares up in critically ill Covid patients, leading to organ damage or dysfunction.

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