Covid, what are Tocilizumab and Sarilumab doing? Economist Report
What emerges from a clinical study of Tocilizumab and Sarilumab. The Economist in-depth study
Good news from Covid-19 departments is hard to find these days. A relentless wave of infections is sweeping hospitals around the world. But clinical trial results of two drugs announced today have just improved prognosis, for both patients and hospitals – writes The Economist .
The two drugs , called tocilizumab and sarilumab, are currently used to reduce inflammation in arthritis patients. Hyper-inflammation, whereby the immune system goes into overdrive and destroys organs, is how covid-19 tends to kill. The search for suitable anti-inflammatory drugs for covid-19 has already found one, dexamethasone. It is a low cost steroid which dampens the immune system in general. Conversely, tocilizumab and sarilumab are more targeted. They are both made of antibodies that block the effect of interleukin-6, a protein that stimulates the immune response and is prominent in patients with covid-19.
The tocilizumab and sarilumab clinical trial enrolled 800 patients hospitalized for covid-19 who were ill enough to require transfer to an intensive care unit (ICU). The study was conducted in six countries, with the majority of participants in Britain (it has an efficient drug trial program with covid-19, which enrolls a quarter of hospitalized patients). Half of the 800 patients received one of the two drugs in addition to standard treatment, while the other half received only standard treatment (including dexamethasone).
Almost 36% of patients in the standard treatment group died, compared with 27% of patients in the group who also received tocilizumab or sarilumab. In other words, it reduced the death rate by about a quarter. Furthermore, patients treated with these drugs recovered faster and were discharged from the hospital seven to ten days earlier. Reducing hospital stay would free up a lot of ICU beds.
The two drugs appear to work equally well, although the results are more certain for tocilizumab, which is an older and more available drug, and was therefore administered to the vast majority of participants in the trial's new therapeutic arm.
Drugs are not cheap, and therefore may be beyond the means of developing countries. In the UK, an intravenous course of treatment costs £ 750-1,000 (about $ 1,000-1,400). The shorter ICU stay compensates for this figure; a day in intensive care costs the country's National Health Service (NHS) around £ 2,000 per patient. And, in general, patients who spend fewer days in the ICU recover faster and need less rehabilitation.
The NHS will begin using tocilizumab immediately for covid-19 patients in the ICU. Hospitals already have supplies of the drug, and the government is working with Roche, a drug manufacturer that makes it, to increase supplies. For now, Britain has banned exports of both tocilizumab and sarilumab. As covid-19 deaths continue, the trial results bring a ray of hope for exhausted patients and healthcare professionals.
(Extract from the press review of Eprcomunicazione )
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/mondo/tocilizumab-sarilumab-covid-cosa-fanno/ on Sun, 10 Jan 2021 06:43:13 +0000.