Health
Another drug shows mortality benefits for severe COVID-19
Tocilizumab (Actemra) showed a slight but statistically significant mortality benefit in patients with severe COVID-19. Press release From a practical recovery test in the UK.
Of the patients treated with tocilizumab, an IL-6 inhibitor used for rheumatoid arthritis and related symptoms, 29% died within 28 days, compared with 33% (rate) of those who received conventional treatment. Ratio 0.86, 95% CI 0.77-0.96, P= 0.007), the researchers said. This is the number needed for 25 treatments to save one additional life.
Tocilizumab also improved the probability of “discharge” after 28 days from 47% to 54% (RR 1.23, 95% CI 1.12-1.34, P<0.0001) Between inpatients of varying severity, from patients requiring oxygen supplementation to patients requiring intubation.
RECOVERY Co-Principal Investigators at Oxford University Peter Horby, MD, PhD in previous exams “Mixed result” “It is unclear which patients will benefit from the treatment.”
“The results of the RECOVERY trial underscore the worst outcomes of COVID-19: the benefits of tocilizumab and dexamethasone in addressing improved survival, shorter hospital stays, and reduced ventilator needs. “” Said collaborator Dr. Martin Landray. , In a group statement at Oxford University.
Ryan Zarychanski, MD, University of Manitoba, Comment on Twitter “In addition to anticoagulant therapy, I think this will become a new standard as the data become clear. This drug is not as cheap as steroids and heparin.”
Current NIH guidelines include Insufficient evidence We recommend or oppose the use of tocilizumab in patients with severe COVID-19 and recommend it in patients who do not require ICU level care.
For patients who did not require mechanical ventilation at the start of the study, a significantly smaller percentage of patients treated with tosirizumab progressed to mechanical ventilation or death compared to those receiving conventional treatment ( 38% and 33%, respectively; RR 0.85, 95% CI 0.78-0.93, P= 0.0005). However, there was no evidence that the drug improved the patient’s chances of stopping ventilation.
Random assessment of COVID-19 therapy The (recovery) trial is a notable and practical trial in finding mortality benefits with cheap steroids. Dexamethasone, And recently FDA-approved lack of mortality in remdesivir, its findings have been controversial by other trials.
Tocilizumab was added to a recovery study in patients requiring oxygen with evidence of inflammation in April 2020 and was enrolled in January 2021 due to sufficient evidence to establish meaningful benefits. Was canceled.
Overall, 2,022 patients were randomized to receive tocilizumab and 2,094 received regular care. In particular, 82% of patients in both groups were treated with systemic steroids such as dexamethasone.
These results have not yet been published in peer-reviewed journals or as preprints, but the authors medRxiv shortly.
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