Roche’s Actemra (tocilizumab) and Sanofi’s Kevzara (sarilumab) have been found to cut the risk of death in critically ill COVID-19 patients in a study led by Imperial College London.
The REMAP-CAP trial – which has not yet been peer-reviewed – is evaluating the effects of certain treatments on survival and the length of time COVID-19 patients need to be in an intensive care unit (ICU).
The latest analysis from this trial found that both Actemra and Kevzara reduced mortality by 8.6%, and also improved recovery times among patients who are critically ill with COVID-19. This reflects a reduction in the relative risk of death by 24% when given to patients within 24 hours of entering intensive care.
On average, patients treated with these drugs were able to leave the ICU around a week earlier than those not receiving these treatments.
Both Actemra and Kevzara are IL-6 receptor agonists and are most commonly used to treat anti-inflammatory conditions, including arthritis.
IL-6 is thought to play a role in driving the overactive inflammatory response in the lungs of critically and severely ill COVID-19 patients.
In earlier studies of both drugs, the benefit of using IL-6 inhibitors has been unclear. Professor Anthony Gordon, lead researcher of the REMAP-CAP study said: “Previous trials using IL-6 receptor agonists have showed no clear benefit on either disease progression or survival in COVID-19 patients, but those studies included less severely ill patients and started treatment at different stages in the disease course.”
This includes Roche’s own phase 3 COVACTA study, in which Actemra did not meet its primary endpoint of improved clinical status in hospitalised adults patients with severe COVID-19-associated pneumonia.
Another study of Sanofi’s Kevzara found that the IL-6 inhibitor was unable to prevent death or help patients come off ventilation among mechanically ventilated COVID-19 patients.
“A crucial difference may be that in our study, critically ill patients were enrolled within 24 hours of starting organ support. This highlights a potential early window for treatment where the sickest patients may gain the most benefit from immune modulation treatment,” said Gordon.
In a statement, the Department of Health and Social Care (DHSC) said that it is ‘working closely’ with Swiss pharma Roche to ensure that supplies of Actemra continue to remain available for UK patients.
“Today’s results are yet another landmark development in finding a way out of this pandemic and, when added to the armoury of vaccines and treatments already being rolled out, will play a significant role in defeating this virus” said Health Secretary Matt Hancock.
“We have worked quickly to ensure this treatment is available to NHS patients without delay, meaning hundreds of lives will be saved,” he added.