Arthritis drug gives new hope to critically ill COVID-19 patients

An international study has shown improved outcomes for critically ill COVID-19 patients treated with an arthritis drug. Supported by the EU-funded PREPARE and RECOVER projects, the study has found that patients given this drug spend less time on organ support while in intensive care.

Called tocilizumab, the drug reduces inflammation by modifying the immune system. Tocilizumab is mainly recommended for the treatment of rheumatoid arthritis and a severe form of arthritis in children known as systemic juvenile idiopathic arthritis. According to a press release posted on the RECOVER project website, the immunosuppressive drug is “99 per cent more likely to reduce deaths and time spent in intensive care among critically ill patients with severe COVID-19, compared to patients who did not receive the treatment.”Given the urgent need for data on effective COVID-19 treatments, the researchers have released these early findings before they’ve been peer reviewed. The team is currently working on publishing the full results. “We still need to see the full data, but this is a very exciting result,” stated Dr Lennie Derde of PREPARE and RECOVER project partner University Medical Center Utrecht in the same press release. “To have a second effective therapy for critically ill patients within months of the start of the pandemic is unprecedented. Specific targeting of the immune response is theoretically attractive, and now this indicates it works.”

The study’s findings were obtained from REMAP-CAP, an international adaptive platform trial for community-acquired pneumonia that is partly funded by the PREPARE project. Designed for use in pandemic situations, REMAP-CAP simultaneously evaluates multiple interventions in critically ill patients to identify the best treatment strategies.

In the study, the researchers analysed the data of 303 randomised patients who were treated with either tocilizumab, sarilumab, anakinra, interferon or no immune modulator. While results are not yet out on the relative benefits of tocilizumab compared to the other immune modulators, early findings showed that patients receiving tocilizumab were more likely to improve than patients given no immune modulation treatment at all. “These early findings show that a single course of treatment with this immune modulating drug can significantly improve the outcomes for the most critically ill COVID-19 patients in intensive care,” remarked Prof. Anthony Gordon of PREPARE project partner Imperial College London in the press release. “Once we have completed the analysis of the full dataset, we hope these findings will allow critical care teams around the world to improve the outcomes of the sickest COVID-19 patients.” The trial data was also analysed and reviewed by outside bodies independent from the trial investigators.

Data analysed from the PREPARE (Platform foR European Preparedness Against (Re-)emerging Epidemics) and RECOVER (Rapid European SARS-CoV-2 Emergency research Response) study also pointed to the ineffectiveness of an antiviral drug called lopinavir/ritonavir in the treatment of COVID-19. The antiviral drug was found to provide no additional benefit to critically ill COVID-19 patients when compared with patients who weren’t given the drug. The PREPARE project ends in January 2021 and RECOVER in February 2022.

For more information, please see:

PREPARE project website

RECOVER project website