The results of research by American researchers give cause for hope. Coronavirus infections who were on ventilators had almost half the risk of dying after receiving a single dose of a drug called tocilizumab.
Tocilizumab in the treatment of COVID-19
The work of scientists from the University of Michigan was published in the scientific journal “Clinical Infectious Diseases”. Tocilizumab (atlizumab) is a monoclonal antibody that weakens the immune system. in rheumatoid arthritis.
The drug, the researchers explained, affects one of the components of the immune system – interleukin 6 (IL-6). In this way mutes the so-called cytokine storm – an overly strong immune system response that damages the lungs and other organs.
Researchers treated 154 critically ill patients with SARS-CoV-2 from early March to late April this year. This is a time when little was known about what would help patients under ventilators.
Half of the patients received a single dose of tocilizumab, most often within 24 hours of being connected to a ventilator.
28 percent died within 18 days of being connected. of those who were treated with tocilizumab and 36% from those who did not receive the drug. This means a 45% reduction in mortality.
Of those who remained in hospital at the end of the study, 82 percent. treated with tocilizumab were disconnected from the ventilator, and in the second group – 53 percent.
At the same time, 54 percent. patients who received the drug developed another infection, usually associated with respirator use pneumonia. Similar problems occurred in only 26 percent. people who did not receive the drug.
Such additional infections usually reduce the survival rate of COVID-19 patients.
Scientists emphasize that more research is needed.
One of the main authors of the work, prof. Jason Pogue explains that more confident results from a randomized British study led him to recommend the steroid drug dexamethasone as the first drug to be given to critically ill COVID-19 patients.
«For a retrospective single-site study, our results are solid. However, at the moment, due to the lack of randomized, controlled trials and a much higher price, we recommend leaving tocilizumab for the treatment of selected patients who experience decompensation during or after taking dexamethasone, or patients whose risk of adverse effects of steroid therapy exceeds the potential benefits ” – emphasizes prof. Pogue.
In his opinion, further research should include combining both drugs and a precise comparison of their effects.
If the therapy based on interleukin 6 targeting proves effective, it will also be important to determine the best doses and timing of drug administration in order to improve the patient’s condition, but minimize side effects – the risk of further infections and disruption of tissue regeneration.
Prof. Pogue also notes that one dose of tocilizumab is 100 times more expensive than the entire treatment with dexamethasone.
She reminds that another drug that acts on IL-6 and calms the cytokine storm, sarilumab does not seem to work against COVID-19.
More information on the pages:
- https://www.eurekalert.org/pub_releases/2020-07/mm-u-dlt071320.php
- https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa954/5870306
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