Nuffield Department of Population Health (NDPH) of Oxford University in the UK has reported results from the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial of Roche’s arthritis drug, tocilizumab, which showed it lowered the risk of death among patients hospitalised with severe Covid-19.
Since March last year, the trial has been analysing various potential Covid-19 treatments.
Tocilizumab is used for treating rheumatoid arthritis and was included in the trial in April last year for treating Covid-19 patients who need oxygen and had evidence of inflammation.
As per the trial steering committee’s view, on 24 January, the recruitment to the tocilizumab arm was stopped as an adequate number of patients were enrolled to establish whether or not the drug had a meaningful benefit.
The trial had 2,022 patients who randomly received an intravenous infusion of tocilizumab and were compared with 2,094 patients who received standard care alone.
Data showed that 29% of the patients in the tocilizumab group died within 28 days versus 33% in the usual care group.
The anti-inflammatory treatment also improved the chances of discharge alive within 28 days from 47% to 54%.
The trial demonstrated that the treatment reduced the time to recovery and the need for mechanical ventilation while no evidence of tocilizumab’s effect on the chance of successful cessation of invasive mechanical ventilation was observed.
Last June, the RECOVERY trial found that an inexpensive steroid, dexamethasone, reduced chances of death in severe Covid-19 patients.
The latest data indicates that a combination treatment of a systemic corticosteroid (such as dexamethasone) plus tocilizumab lowers mortality by about one third for patients needing simple oxygen and nearly one half for those needing invasive mechanical ventilation.
The University of Oxford Nuffield Department of Medicine Emerging Infectious Diseases professor Peter Horby said: “Previous trials of tocilizumab had shown mixed results, and it was unclear which patients might benefit from the treatment.
“We now know that the benefits of tocilizumab extend to all Covid patients with low oxygen levels and significant inflammation. The double impact of dexamethasone plus tocilizumab is impressive and very welcome.”