Treating critically ill COVID-19 patients with drugs typically used for arthritis may significantly improve survival, a landmark study has found.
The findings, which have not yet been peer-reviewed, come from the REMAP-CAP trial, which evaluates the effect of treatments on a combination of survival and length of time patients need support in an intensive care unit (ICU).
Initial findings reported in November showed that tocilizumab, a drug used to treat arthritis, was likely to improve outcomes among critically ill COVID-19 patients. But the impact on patient survival and length of time on organ support in ICU was not clear at that time.
Now, the latest analysis shows that tocilizumab and a second drug called sarilumab – both types of immune modulators called IL-6 receptor antagonists – have a significant impact on patient survival, reducing mortality by 8.5%.
Furthermore, the treatment also improved recovery so that on average patients were able to be discharged from the intensive care unit (ICU) about a week earlier.
The latest analysis is published in a pre-print available on medRxiv, with the findings submitted to a peer-reviewed journal.
“This is a significant finding which could have immediate implications for the sickest patients with COVID-19,” said Professor Anthony Gordon, Chair in Anaesthesia and Critical Care at Imperial College London and a Consultant in Intensive Care Medicine at Imperial College Healthcare NHS Trust.
“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,” explained Professor Gordon. “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.”
At the end of last year, positive early findings on tocilizumab were released before the full data had been collected. With the full analysis now available, researchers are confident the findings could have immediate clinical implications for patients.
Responding to this news, Professor Cheng-Hock Toh, academic vice president of the Royal College of Physicians said: “This is excellent news for patients and for the clinicians treating them. Not only can these drugs save lives, they can help get people home from hospital sooner, increasing our capacity to treat others.
“This and other rapid developments show how crucial the NHS is to global research. Hospitals and clinicians across the UK have played a key role, providing around half of the research sites and three quarters of the patients.
“As we reset the NHS following the pandemic, we need to make sure more doctors are able to participate in research. As the secretary of state, Matt Hancock, said at our conference, we need to create the space for doctors to be engaged in the development of medicine, as well as its delivery.
“Hospital boards must commit to it and funding needs to be targeted at the areas where more people suffer ill health. Most importantly, we need to increase the number of doctors by doubling medical school places. That will reduce the pressure on us and free up more time for involvement in research, as well as education and quality improvement.”
