Researchers from the University of Michigan have found that tocilizumab, an immunosuppressive drug used to treat arthritis, may also be effective in improving survival rates for COVID-19 patients who require mechanical ventilation.
The majority of COVID-19 deaths come from terminal respiratory failure. In some cases, COVID-19 causes hyper inflammation from an uncontrolled release of cytokines, immune cells, that ends up attacking the patient's body as well as the infection. A significant number of such 'cytokine storms' result in death.
One reason for interest in tocilizumab is that it blocks IL-6, a molecule in the body that reacts to infection. It can thus theoretically reduce the impact, and chance, of a cytokine storm.
The first indication that tocilizumab may treat patients with COVID-19 came from France in late April. In a preliminary trial, 64 patients with moderate to severe COVID-19 symptoms were treated with the drug alongside standard care and then compared to those receiving only standard care. At the end of the study, the researchers said that those on tocilizumab required significantly less ventilator support than other patients. On top of this, they observed no adverse side effects from the drug that weren't common to those under standard care too.
A new study from the University of Michigan seems to have echoed these results. In their trial, researchers gave the drug to 78 patients on ventilators. In the end, they found that patients receiving the drug were 45% less likely to die than those who didn't. This is significant considering that over half of those who end up on ventilators die.
The results come with one caveat, however. As the doctors knew which patients received the drug and which didn't, the researchers warn that their results may have been biased. They say that doctors may have picked people in the tocilizumab group who had a better chance of survival regardless of drug-use.
To better understand how the drug may affect the treatment of COVID-19, in late May, the drug's manufacturer, Roche, said that it would perform a clinical trial of the drug alongside remdesivir.
Sources: MIT Technology Review, Science Mag, News Medical